Individual
RAJENDER REDDY JINNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
682 UNION AVE, LONG ISLAND FQHC, INC., WESTBURY, NY 11590-3552
(516) 571-9535
Mailing address
380 NASSAU RD, LONG ISLAND FQHC, INC., ROOSEVELT, NY 11575-1343
(516) 571-8600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
186081
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01340096
—
NY
Enumeration date
03/28/2006
Last updated
01/24/2014
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