Basic Information
| Provider Information | |||||||||
| NPI: | 1922075928 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PATRICIA A. REDDY, M.D., P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2025 TECHNOLOGY PKWY | ||||||||
| Address2: | SUITE# 212 | ||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170509400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177912620 | ||||||||
| FaxNumber: | 7177912629 | ||||||||
| Practice Location | |||||||||
| Address1: | 2025 TECHNOLOGY PKWY | ||||||||
| Address2: | SUITE# 212 | ||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170509400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177912620 | ||||||||
| FaxNumber: | 7177912629 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2006 | ||||||||
| LastUpdateDate: | 05/19/2022 | ||||||||
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| AuthorizedOfficialLastName: | REDDY | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
| AuthorizedOfficialMiddleName: | ANNE | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/ PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 7177912620 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VE0102X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Reproductive Endocrinology | 208600000X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | 363LW0102X | X | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 363LX0001X | X | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 01503701 | 01 | PA | HIGHMARK BC RENDERING # | OTHER | 01503701 | 01 | PA | KEYSTONE HLTH PLAN RENDER | OTHER | RE1751023 | 01 | PA | BLUE SHIELD BILLING # | OTHER | 0205300 | 01 | PA | HIGHMARK BC BILLING # | OTHER | 074706 | 01 | PA | BLUE SHIELD RENDERING # | OTHER | C29074 | 01 | PA | HEALTH AMERICA BILLING # | OTHER | 02505300 | 01 | PA | KEYSTONE HLTH PLAN BILLIN | OTHER | 4598939 | 01 | PA | AETNA BILLING # | OTHER | 588369 | 01 | PA | AETNA RENDERING # | OTHER |