Healthcare Provider Details

I. General information

NPI: 1609847656
Provider Name (Legal Business Name): REDDY CARE WALK IN CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 TRANSIT RD SUITE #3
E AMHERST NY
14051-2606
US

IV. Provider business mailing address

6161 TRANSIT RD SUITE #3
E AMHERST NY
14051-2606
US

V. Phone/Fax

Practice location:
  • Phone: 716-688-6161
  • Fax:
Mailing address:
  • Phone: 716-688-6161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number141380
License Number StateNY

VIII. Authorized Official

Name: DR. SIVAKUMAR REDDY
Title or Position: OWNER
Credential: MD
Phone: 716-688-6161