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Vijaya Sen Reddy Gaddam

Dentist in Albany, NY. Individual provider (NPI-1).

NPI number1043674633
StatusActive
Last updated in NPPESJul 21, 2022

Details

NPI
1043674633
Entity type
Individual (NPI-1)
Name
Vijaya Sen Reddy Gaddam
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 8, 2016
Last updated
Jul 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist059473NYYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

1873 Western Ave
Suite 200
Albany, NY 12203-5028

Phone 518-869-1044

Mailing address

201 Dey St
Apt. 174
Harrison, NJ 07029-1787

Phone 940-395-6265

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