Provider Demographics
NPI:1538162656
Name:LAKSHMI-REDDY, VIJAYA S (MD)
Entity type:Individual
Prefix:
First Name:VIJAYA
Middle Name:S
Last Name:LAKSHMI-REDDY
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:40 STIRLING RD STE 205
Mailing Address - Street 2:SURGICARE ANESTHESIA OF CENTRAL JERSEY
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-5900
Mailing Address - Country:US
Mailing Address - Phone:908-769-1084
Mailing Address - Fax:908-769-4139
Practice Address - Street 1:40 STIRLING RD STE 205
Practice Address - Street 2:SURGICARE ANESTHESIA OF CENTRAL JERSEY
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-5900
Practice Address - Country:US
Practice Address - Phone:908-769-1084
Practice Address - Fax:908-769-4139
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2021-02-18
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Provider Licenses
StateLicense IDTaxonomies
NJMA 68188174400000X
MAMA68188207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8630909Medicaid
NJ043381Medicare ID - Type Unspecified
NJ227296Medicare PIN
NJ8630909Medicaid