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General NPI Number Information
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NPI Number | 1790753416
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Entity Type | Individual
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Provider Name | CHENDRA REDDY MD
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 769 ONDERDONK AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-3711
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Country | US
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Telephone | 718-334-6191
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Fax |
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Provider Business Mailing Address
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Address Line | 3 KEMP LN
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3618
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Country | US
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Telephone | 516-873-7982
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Fax |
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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 | 209290
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License Number State | NY
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