Individual
CHENNA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
433 BELLEVUE AVE, 4TH FLOOR, TRENTON, NJ 08618-4501
(609) 815-2677
(609) 815-2682
Mailing address
P.O. BOX 8500-1601, PHILADELPHIA, PA 19178-1601
(609) 815-7810
(609) 815-7814
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25MA03387000
NJ
207Q00000X
Family Medicine Physician
Primary
25MA03387000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0972801
—
NJ
Enumeration date
08/31/2006
Last updated
08/17/2011
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