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General NPI Number Information
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NPI Number | 1053295923
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Entity Type | Individual
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Provider Name | MATTHEW REDA PA
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Gender | Male
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 10/12/2025
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Provider Practice Location Address
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Address Line | 731 STATE ROUTE 35 UNIT G
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City | OCEAN
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State | NJ
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Zip | 07712-4767
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Country | US
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Telephone | 848-306-5957
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Fax |
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Provider Business Mailing Address
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Address Line | 1 JULIA LN
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City | HAZLET
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State | NJ
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Zip | 07730-4004
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00951000
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License Number State | NJ
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