Healthcare Provider Details

I. General information

NPI: 1437838182
Provider Name (Legal Business Name): DIVYA REDDY VOLADRI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 MAIN ST FL 5
BUFFALO NY
14203-1009
US

IV. Provider business mailing address

1001 MAIN ST FL 5
BUFFALO NY
14203-1009
US

V. Phone/Fax

Practice location:
  • Phone: 716-323-0255
  • Fax: 716-323-0294
Mailing address:
  • Phone: 716-323-0255
  • Fax: 716-323-0294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: