Provider Demographics
NPI:1699013045
Name:KATTA, PRATYUSHA REDDY (MD)
Entity Type:Individual
Prefix:
First Name:PRATYUSHA
Middle Name:REDDY
Last Name:KATTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MADEIRA CT
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3144
Mailing Address - Country:US
Mailing Address - Phone:732-857-7742
Mailing Address - Fax:
Practice Address - Street 1:175 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-2099
Practice Address - Country:US
Practice Address - Phone:609-914-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD452969208M00000X
NJ25MA09342900208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist