Provider Demographics
NPI:1518257856
Name:NALLAPAREDDYGARI, VENKATARANGA REDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:VENKATARANGA
Middle Name:REDDY
Last Name:NALLAPAREDDYGARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:55 BRUNSWICK WOODS DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5601
Mailing Address - Country:US
Mailing Address - Phone:732-444-8287
Mailing Address - Fax:732-200-1087
Practice Address - Street 1:55 BRUNSWICK WOODS DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-444-8287
Practice Address - Fax:732-200-1087
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD446648207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102763468Medicaid
PA257062Medicare UPIN
NJ531590Medicare UPIN
PA102763468Medicaid
PAP01536955Medicare PIN
PA257062FLTMedicare PIN