Healthcare Provider Details

I. General information

NPI: 1306461355
Provider Name (Legal Business Name): ASHWIN N REDDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD STE 2E99
NEWARK DE
19718-2200
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD STE 2E99
NEWARK DE
19718-2200
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-5982
  • Fax: 302-733-6081
Mailing address:
  • Phone: 302-733-5982
  • Fax: 302-733-6081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number125.076109
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberC1-0029607
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: