Provider Demographics
NPI:1972519270
Name:REDDY, RAM K (MD)
Entity type:Individual
Prefix:MR
First Name:RAM
Middle Name:K
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 1:212 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1116
Mailing Address - Country:US
Mailing Address - Phone:201-659-4095
Mailing Address - Fax:
Practice Address - Street 1:212 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1116
Practice Address - Country:US
Practice Address - Phone:201-659-4095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2009-02-05
Deactivation Date:2007-11-09
Deactivation Code:
Reactivation Date:2008-08-05
Provider Licenses
StateLicense IDTaxonomies
NJMA30017207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology