Provider Demographics
NPI:1033321534
Name:VENU REDDY MD & VJ REDDY MD LLP
Entity Type:Organization
Organization Name:VENU REDDY MD & VJ REDDY MD LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALARICE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-942-7707
Mailing Address - Street 1:1319 PUNAHOU ST STE 1160
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1089
Mailing Address - Country:US
Mailing Address - Phone:808-942-7707
Mailing Address - Fax:800-955-3301
Practice Address - Street 1:1319 PUNAHOU ST STE 1160
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1089
Practice Address - Country:US
Practice Address - Phone:808-942-7707
Practice Address - Fax:800-955-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI20162080A0000X
HI124452080P0202X
HI17632080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI034484-02Medicaid
HI536419Medicaid
HI030227-01Medicaid
HI034484-01Medicaid
HIH89969Medicare UPIN
HID43614Medicare UPIN
HI030227-01Medicaid