Individual
DR. REDDY B ALLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
73 PARK ST, MONTCLAIR, NJ 07042
(973) 746-0595
(973) 746-1848
Mailing address
73 PARK ST, MONTCLAIR, NJ 07042
(973) 746-0595
(973) 746-1848
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA06044500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6560504
—
NJ
Enumeration date
05/03/2006
Last updated
05/28/2014
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