Basic Information
| Provider Information | |||||||||
| NPI: | 1457797276 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | GALA | ||||||||
| FirstName: | RAJ | ||||||||
| MiddleName: | JITENDRA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 39 HOSPITAL AVE | ||||||||
| Address2: | |||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068106027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037449700 | ||||||||
| FaxNumber: | 2037449701 | ||||||||
| Practice Location | |||||||||
| Address1: | 39 HOSPITAL AVE | ||||||||
| Address2: | |||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037449700 | ||||||||
| FaxNumber: | 2037449701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2013 | ||||||||
| LastUpdateDate: | 08/03/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0117X | 080123 | GA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | 207XS0117X | 62500 | CT | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
No ID Information.