Provider Demographics
NPI:1508420696
Name:REDDY, VARUN (MD)
Entity Type:Individual
Prefix:
First Name:VARUN
Middle Name:
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 ROUTE 38 STE A
Mailing Address - Street 2:
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-2702
Mailing Address - Country:US
Mailing Address - Phone:856-222-1975
Mailing Address - Fax:856-222-0721
Practice Address - Street 1:1261 ROUTE 38 STE A
Practice Address - Street 2:
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036-2702
Practice Address - Country:US
Practice Address - Phone:856-222-1975
Practice Address - Fax:856-222-0721
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA12221300207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine