Healthcare Provider Details

I. General information

NPI: 1023904034
Provider Name (Legal Business Name): GAGANA PUTCHALA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SWETHA PUTCHALA

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 POCONO ROAD, ST CLARE'S HEALTH DENVILLE HOSPITAL, INTERNAL MEDICINE
DENVILLE NJ
07834
US

IV. Provider business mailing address

25 POCONO ROAD, ST CLARE'S HEALTH DENVILLE HOSPITAL, INTERNAL MEDICINE
DENVILLE NJ
07834
US

V. Phone/Fax

Practice location:
  • Phone: 973-625-6000
  • Fax:
Mailing address:
  • Phone: 973-625-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: