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General NPI Number Information
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NPI Number | 1023181138
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Entity Type | Individual
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Provider Name | SAILAJA SIVAREDDY M.D
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Gender | Female
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 8924 146TH ST
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City | JAMAICA
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State | NY
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Zip | 11435-3640
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Country | US
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Telephone | 718-715-1764
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Fax | 718-885-9311
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Provider Business Mailing Address
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Address Line | 14724 VILLAGE RD SUITE # GB
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City | JAMAICA
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State | NY
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Zip | 11435-6348
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Country | US
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Telephone | 718-715-1764
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Fax | 718-885-9311
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 241662
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 241662
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License Number State | NY
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