Provider Demographics
NPI:1720294853
Name:REDDY, RAJESH (DO)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:REDDY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3025 C G ZINN RD
Mailing Address - Street 2:
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372-1131
Mailing Address - Country:US
Mailing Address - Phone:610-384-2211
Mailing Address - Fax:610-384-2340
Practice Address - Street 1:3025 C. G ZINN ROAD
Practice Address - Street 2:
Practice Address - City:THORNDALE
Practice Address - State:PA
Practice Address - Zip Code:19372-1131
Practice Address - Country:US
Practice Address - Phone:610-384-2211
Practice Address - Fax:610-384-2340
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS013787207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine