Individual
TRISHLA REDDY KANTHALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1692 OAK TREE RD, EDISON, NJ 08820-2853
(732) 692-0542
Mailing address
14 INDEPENDENCE DR, EDISON, NJ 08820-1616
(732) 692-0542
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MB10244400
NJ
208100000X
Physical Medicine & Rehabilitation Physician
OS018881
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003625574
HIGHMARK CHOICE/PREMIER BS/MEDICARE ADVANTAGE
PA
05
—
103343083-0001
—
PA
05
—
103343083-0002
—
PA
01
—
1124361944
INDEPENDENCE BC/AMERIHEALTH
PA
01
—
588234J67
MEDICARE
PA
Enumeration date
03/29/2013
Last updated
03/17/2018
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