Shravan G Reddy, MD
Family Medicine in East Northport, NY. Individual provider (NPI-1).
NPI number1124519087
StatusActive
Last updated in NPPESSep 25, 2026
Details
- NPI
- 1124519087
- Entity type
- Individual (NPI-1)
- Name
- Shravan G Reddy
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 25, 2018
- Certification date
- Sep 24, 2026
- Last updated
- Sep 25, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 345008-01 | NY | Yes |
| 207Q00000X | Family Medicine | 25MA11099300 | NJ |
Practice location
558 Larkfield RdEast Northport, NY 11731-4204
Phone 631-486-7459
Mailing address
558 Larkfield RdEast Northport, NY 11731-4204
Phone 631-486-7459
Other practice locations
278 Route Nj-10 West
Succasunna, NJ 07876
Succasunna, NJ 07876
Phone 862-477-5288
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All 5 Family Medicine Physician providers in East Northport · All 619 providers in East Northport
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