| Doctor Name: | DR. SESHAMMA THIKKAVARAPU REDDY |
| NPI Number: | 1508020298 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D, PH.D |
| License Number: | |
| Business Practice Address: | 2 Executive Boulevard, Suite # 102 Oralcdx Laboratories Suffern, NY - 10901 |
| Business Phone Number: | 8453687402 |
| Business Fax Number: | 8453687462 |
| Mailing Address: | 260 Franklin Tpke, Apt # 405 MAHWAH |
| State: | NJ |
| Postal Code: | 074301850 |
| Phone Number: | 8046877251 |
| Fax Number: | |
| NPI Enumeration Date: | 07/11/2008 |
| NPI Last Update Date: | 11/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |