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General NPI Number Information
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NPI Number | 1306957436
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Entity Type | Individual
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Provider Name | CHENNA REDDY MD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 433 BELLEVUE AVE 4TH FLOOR
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City | TRENTON
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State | NJ
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Zip | 08618-4501
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Country | US
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Telephone | 609-815-2677
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Fax | 609-815-2682
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Provider Business Mailing Address
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Address Line | P.O. BOX 8500-1601
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City | PHILADELPHIA
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State | PA
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Zip | 19178-1601
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Country | US
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Telephone | 609-815-7810
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Fax | 609-815-7814
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MA03387000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA03387000
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License Number State | NJ
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