Healthcare Provider Details

I. General information

NPI: 1518528538
Provider Name (Legal Business Name): ARUNATEJA CHENNAREDDY NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 STONE ST
RAHWAY NJ
07065-2742
US

IV. Provider business mailing address

245 NEW RD
MONMOUTH JUNCTION NJ
08852-2318
US

V. Phone/Fax

Practice location:
  • Phone: 732-499-6031
  • Fax:
Mailing address:
  • Phone: 732-882-9197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberC-APN.0106194-C-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number26NR15253800
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00949700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: