Provider Demographics
NPI:1730761271
Name:SAGIREDDY, SOWMYA (MD)
Entity type:Individual
Prefix:MS
First Name:SOWMYA
Middle Name:
Last Name:SAGIREDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 OCEAN PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:718-616-3000
Mailing Address - Fax:
Practice Address - Street 1:2601 OCEAN PARKWAY CONEY ISLAND HOSPITAL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-616-3779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-23
Last Update Date:2022-07-18
Deactivation Date:2022-02-24
Deactivation Code:
Reactivation Date:2022-07-18
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program