1972537371 NPI number — DR. SATISH REDDY M.D

Table of content: DR. SATISH REDDY M.D (NPI 1972537371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972537371 NPI number — DR. SATISH REDDY M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REDDY
Provider First Name:
SATISH
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972537371
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
140 E 83RD ST
Provider Second Line Business Mailing Address:
APT 10 C
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10028-1929
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-580-5850
Provider Business Mailing Address Fax Number:
212-665-9412

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1185 PARK AVE
Provider Second Line Business Practice Location Address:
SUITE 1 L
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10128-1308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-580-5850
Provider Business Practice Location Address Fax Number:
212-665-9412
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  184084 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0800X , with the licence number: 184084 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05658 . This is a "GHI MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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