D S Reddy Physician P.C

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

126326 Issued in NY

Legal business name

D S REDDY PHYSICIAN P.C

Practice address

732 East Park Ave
Long Beach, NY 11561

Phone

(516) 431-2064

Fax

(516) 431-1090

NPI assigned

Mar 28, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Devi Srinivas Reddy, MD

Title

President

Phone

(516) 431-2064

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1033170352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 EAST PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "11561",
            "telephone_number": "516-431-2064",
            "fax_number": "516-431-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 EAST PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "11561",
            "telephone_number": "516-431-2064",
            "fax_number": "516-431-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D S REDDY PHYSICIAN P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "DEVI",
        "authorized_official_middle_name": "SRINIVAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-431-2064",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "126326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00507204",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.