Healthcare Provider Details

I. General information

NPI: 1972182749
Provider Name (Legal Business Name): HARITHA REDDY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1468 MADISON AVE
NEW YORK NY
10029-6508
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL # 1259
NEW YORK NY
10029-6504
US

V. Phone/Fax

Practice location:
  • Phone: 732-233-5115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number342857
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: