Healthcare Provider Details

I. General information

NPI: 1154053221
Provider Name (Legal Business Name): ROHIT REDDY MARTHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 ESSEX ST STE 403
HACKENSACK NJ
07601-3247
US

IV. Provider business mailing address

211 ESSEX ST STE 403
HACKENSACK NJ
07601-3247
US

V. Phone/Fax

Practice location:
  • Phone: 201-228-9595
  • Fax:
Mailing address:
  • Phone: 201-228-9595
  • Fax: 706-596-4456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA12697600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: