Basic Information
| Provider Information | |||||||||
| NPI: | 1346691771 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MANDADI | ||||||||
| FirstName: | VIKAS | ||||||||
| MiddleName: | REDDY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1438 S GRAND BLVD | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631041027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149774850 | ||||||||
| FaxNumber: | 3149774880 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 HARRISBURG AVE | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176032951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177404100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2016 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | MD475788 | PA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.