Provider Demographics
NPI:1972537371
Name:REDDY, SATISH (MD)
Entity type:Individual
Prefix:DR
First Name:SATISH
Middle Name:
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:140 E 83RD ST
Mailing Address - Street 2:APT 10 C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1929
Mailing Address - Country:US
Mailing Address - Phone:212-580-5850
Mailing Address - Fax:212-665-9412
Practice Address - Street 1:1185 PARK AVE
Practice Address - Street 2:SUITE 1 L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1308
Practice Address - Country:US
Practice Address - Phone:212-580-5850
Practice Address - Fax:212-665-9412
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY184084207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05658OtherGHI MEDICARE
NY05658OtherGHI MEDICARE