MEDICARE: KUMAR S 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	207X00000X	Orthopaedic Surgery Physician	104996	NY

General Provider Information

NPI Number	:	1952340085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KUMAR S REDDY MD

Provider Business Mailing Address
First Line	:	6860 AUSTIN ST
Second Line	:	SUITE 502
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4245
Country	:	US
Telephone Number	:	718-925-6263
Fax Number	:	718-925-6251

Provider Business Practice Location Address
First Line	:	6860 AUSTIN ST
Second Line	:	SUITE 502
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4245
Country	:	US
Telephone Number	:	718-925-6263
Fax Number	:	718-925-6251

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	11/04/2008

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