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NPI Code Detail

MEDICARE: SAROJA YARRAMREDDY M.D.

MEDICARE: SAROJA YARRAMREDDY 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
1207Q00000XFamily Medicine Physician245171NY

Other Identifiers

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

General Provider Information

NPI Number : 1487841318
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAROJA YARRAMREDDY M.D.
Provider Business Mailing Address
First Line : 80 MARCUS DR
Second Line : PROVIDER ENROLLMENT
City : MELVILLE
State : NY
Zip : 11747-4230
Country : US
Telephone Number : 631-391-8354
Fax Number : 631-454-4163
Provider Business Practice Location Address
First Line : 11120 MERRICK BLVD
Second Line : JHMC-DTC
City : JAMAICA
State : NY
Zip : 11433-4016
Country : US
Telephone Number : 718-206-9888
Fax Number : 718-206-3033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2007
Last Update Date : 01/15/2014

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