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Individual

DR. VIJAYA LINGA REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16 4TH ST, SUITE C, MALONE, NY 12953-1340
(518) 481-2801
(518) 481-2689
Mailing address
908 NIAGARA FALLS BLVD, SUITE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-3302
(716) 332-3525

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
122167
NY
208800000X
Urology Physician
19957
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201586B
PSC MEDICARE PROVIDER #
NC
01
85084
BCNC
NC
05
8985084
NC
Enumeration date
02/21/2006
Last updated
05/01/2013
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