Healthcare Provider Details

I. General information

NPI: 1902460132
Provider Name (Legal Business Name): MADAN MOHAN REDDY PALURU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VALLEY HEALTH PLZ
PARAMUS NJ
07652-3628
US

IV. Provider business mailing address

1 VALLEY HEALTH PLZ
PARAMUS NJ
07652-3628
US

V. Phone/Fax

Practice location:
  • Phone: 201-634-5722
  • Fax: 201-986-4704
Mailing address:
  • Phone: 201-634-5722
  • Fax: 201-986-4704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4351044667
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: