MEDICARE: DR. ASHWINI P. REDDY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0201X	Pediatric Allergy/Immunology Physician	MD456107	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396944906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHWINI P. REDDY M.D.

Provider Business Mailing Address
First Line	:	20631 KUYKENDAHL ROAD
Second Line	:	SUITE 100
City	:	SPRING
State	:	TX
Zip	:	77379
Country	:	US
Telephone Number	:	281-453-1001
Fax Number	:	281-803-5515

Provider Business Practice Location Address
First Line	:	3500 CIVIC CENTER BLVD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4395
Country	:	US
Telephone Number	:	215-590-1000
Fax Number	:	215-590-2180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	11/19/2018

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