Provider Demographics
NPI:1962228239
Name:KESHAVA REDDY, SWATHI (MBBS)
Entity type:Individual
Prefix:
First Name:SWATHI
Middle Name:
Last Name:KESHAVA REDDY
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 NEW SCOTLAND AVE
Mailing Address - Street 2:DEPT OF PEDIATRICS
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:516-262-5588
Mailing Address - Fax:518-262-5589
Practice Address - Street 1:43 NEW SCOTLAND AVE
Practice Address - Street 2:DEPT OF PEDIATRICS
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:516-262-5588
Practice Address - Fax:518-262-5589
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY65039390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program