Individual
DR. NITIN PUTCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
103 RIVER RD, STE 101, EDGEWATER, NJ 07020-1016
(201) 308-8995
(201) 917-3603
Mailing address
103 RIVER RD, STE 101, EDGEWATER, NJ 07020-1016
(201) 308-8995
(201) 917-3603
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
09614400
NJ
208100000X
Physical Medicine & Rehabilitation Physician
53503
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008057927
—
CT
01
—
P01493626
RR MEDICARE
CT
Enumeration date
02/14/2011
Last updated
12/23/2016
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