Provider Demographics
NPI:1023493749
Name:REDDY, NEERAJA KESHAVAN (MS)
Entity type:Individual
Prefix:MS
First Name:NEERAJA
Middle Name:KESHAVAN
Last Name:REDDY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4247 LOCUST ST
Mailing Address - Street 2:620 FAIRFAX APARTMENTS
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5252
Mailing Address - Country:US
Mailing Address - Phone:508-564-2490
Mailing Address - Fax:
Practice Address - Street 1:4247 LOCUST ST
Practice Address - Street 2:620 FAIRFAX APARTMENTS
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5252
Practice Address - Country:US
Practice Address - Phone:508-564-2490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPGC000026170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS