Provider Demographics
NPI:1548247752
Name:REDDY, LOKESH G (MD)
Entity type:Individual
Prefix:DR
First Name:LOKESH
Middle Name:G
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LEGENDARY CIR
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-1077
Mailing Address - Country:US
Mailing Address - Phone:914-723-7202
Mailing Address - Fax:914-725-7457
Practice Address - Street 1:688 WHITE PLAINS RD STE 221
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5015
Practice Address - Country:US
Practice Address - Phone:914-723-7202
Practice Address - Fax:914-725-7457
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192480207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01453098Medicaid
NYF72317Medicare UPIN
NY01453098Medicaid