Provider Demographics
NPI:1366437220
Name:REDDY, UMA P (MD)
Entity type:Individual
Prefix:DR
First Name:UMA
Middle Name:P
Last Name:REDDY
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 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4918
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:530 NEW BRUNSWICK AVENUE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3674
Practice Address - Country:US
Practice Address - Phone:732-442-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04518600207P00000X, 207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00642202OtherRAILROAD CARRIER
NJ7943300Medicaid
NJ91443OtherAMERIGROUP
NJ8167605Medicaid
NJP00642202OtherRAILROAD CARRIER
NJ027478MK3Medicare PIN
NJ91443OtherAMERIGROUP
NJ027478TM8Medicare PIN
NJ027478S6SMedicare PIN
NJ027478MK5Medicare PIN
NJ027478Medicare PIN
NJE98161Medicare UPIN
NJ027478NSEMedicare PIN
NJ027478P7EMedicare PIN