Individual
DR. MALLIKARJUNA D REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7218 164TH ST, FLUSHING, NY 11365-4222
(718) 969-6640
(718) 969-1050
Mailing address
7218 164TH ST, FLUSHING, NY 11365-4222
(718) 969-6640
(718) 969-1050
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
182618
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01281516
—
NY
Enumeration date
10/05/2005
Last updated
10/12/2011
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