MEDICARE: LALITHA M REDDY MD

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	207R00000X	Internal Medicine Physician	1514601	NY

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	:	1487754693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LALITHA M REDDY MD

Provider Business Mailing Address
First Line	:	9413 FLATLANDS AVENUE
Second Line	:	SUITE 101 WEST
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3726
Country	:	US
Telephone Number	:	718-257-6615
Fax Number	:	718-272-3365

Provider Business Practice Location Address
First Line	:	9413 FLATLANDS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3726
Country	:	US
Telephone Number	:	718-257-6615
Fax Number	:

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	02/15/2012

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