MEDICARE: VIJAYA S LAKSHMI-REDDY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MA 68188	NJ
2	207L00000X	Anesthesiology Physician	MA68188	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538162656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIJAYA S LAKSHMI-REDDY M.D.

Provider Business Mailing Address
First Line	:	40 STIRLING RD STE 205
Second Line	:	SURGICARE ANESTHESIA OF CENTRAL JERSEY
City	:	WATCHUNG
State	:	NJ
Zip	:	07069-5900
Country	:	US
Telephone Number	:	908-769-1084
Fax Number	:	908-769-4139

Provider Business Practice Location Address
First Line	:	40 STIRLING RD STE 205
Second Line	:	SURGICARE ANESTHESIA OF CENTRAL JERSEY
City	:	WATCHUNG
State	:	NJ
Zip	:	07069-5900
Country	:	US
Telephone Number	:	908-769-1084
Fax Number	:	908-769-4139

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	02/18/2021

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