Individual
MISS NISHA REDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 BOWMAN DR STE E355, VOORHEES, NJ 08043-9643
(856) 247-7210
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MB11593700
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0859672
—
NJ
Enumeration date
03/06/2017
Last updated
10/25/2024
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