Bhagyam Chenna Reddy, M. D.

Individual provider Active NPI Internal Medicine Physician · West Trenton, NJ

NPI 1033200993 · NPPES record last updated Dec 22, 2010

Key facts

NPI
1033200993
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
25MA05062500 (NJ)
Practice address
301 Sullivan Way
West Trenton, NJ 08628-3406
Phone
(609) 633-1500
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
State of New Jersey Omb Centralized Payroll Past
since Jan 1, 2013
Accepting new patients
State of New Jersey Omb Centralized Payroll Past
since Jan 1, 2013
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA05062500 NJ Yes

Addresses

Primary practice location

301 Sullivan Way
West Trenton, NJ 08628-3406

Mailing address

301 Sullivan Way
West Trenton, NJ 08628-3406
Phone (609) 633-1500

Other identifiers

IdentifierTypeStateIssuer
716738C2DOtherNJMEDICARE PROVIDER NUMBER

Other providers in West Trenton, NJ

All providers in West Trenton, NJ · Internal Medicine Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.