Reddy, Gautam M.

Reddy, Gautam M. is an sole proprietor health care provider with primary practice located at 210 E Sunrise Hwy Ste. 304, Valley Stream NY 11581-1329. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Reddy, Gautam M. can be contacted via phone (516) 825-8484.

Contact Information

Primary practice address
210 E Sunrise Hwy Ste. 304 Valley Stream NY 11581-1329
Phone: (516) 825-8484
Fax: (516) 825-8491
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 200237 New York

Profile Details

NPI number 1235158585
LBN Legal business name Reddy, Gautam M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235158585 NPPES
New York MEDICAID 01918863

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