MEDICARE: LOKA NARAYAN REDDY MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	25MA02708700	NJ

General Provider Information

NPI Number	:	1174763080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOKA NARAYAN REDDY MD PA

Provider Business Mailing Address
First Line	:	1400 KENNEDY BLVD
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-1932
Country	:	US
Telephone Number	:	201-330-9595
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 KENNEDY BLVD
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-1932
Country	:	US
Telephone Number	:	201-330-9595
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LOKA N REDDY
Credential	:	MD PA
Telephone Number	:	201-330-9595

Provider Enumeration Date	:	03/05/2009
Last Update Date	:	03/05/2009

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