Provider Demographics
NPI:1679852875
Name:ARAVINDA REDDY MD PA
Entity Type:Organization
Organization Name:ARAVINDA REDDY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARAVINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-861-9550
Mailing Address - Street 1:1089 NEW DOVER RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1421
Mailing Address - Country:US
Mailing Address - Phone:732-673-3057
Mailing Address - Fax:908-576-3456
Practice Address - Street 1:240 WILLIAMSON ST
Practice Address - Street 2:SUITE 205
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3674
Practice Address - Country:US
Practice Address - Phone:908-289-8340
Practice Address - Fax:908-576-3456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
NJ25MA08807500207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty