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General NPI Number Information
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NPI Number | 1134415961
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Entity Type | Individual
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Provider Name | KIRAN V REDDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 12/16/2016
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Provider Practice Location Address
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Address Line | 2200 NORTHERN BLVD SUITE 112
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City | GREENVALE
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State | NY
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Zip | 11548-1219
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Country | US
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Telephone | 516-484-6777
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Fax | 516-484-0037
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Provider Business Mailing Address
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Address Line | 2200 NORTHERN BLVD SUITE 112
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City | GREENVALE
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State | NY
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Zip | 11548-1219
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Country | US
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Telephone | 516-484-6777
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Fax | 516-484-0037
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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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 284300-1
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License Number State | NY
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