Healthcare Provider Details

I. General information

NPI: 1811458458
Provider Name (Legal Business Name): NEHA REDDY LCAT, BC-DMT, SEP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 03/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W 56TH ST APT 923
NEW YORK NY
10019-3569
US

IV. Provider business mailing address

500 W 56TH ST APT 923
NEW YORK NY
10019-3569
US

V. Phone/Fax

Practice location:
  • Phone: 917-755-1332
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number001541
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: