Provider Demographics
NPI:1629663786
Name:PURCHLA, MAGDALENA ALEKSANDRA
Entity type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:ALEKSANDRA
Last Name:PURCHLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:
Practice Address - Street 1:630 COMMONS WAY
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2806
Practice Address - Country:US
Practice Address - Phone:908-603-8697
Practice Address - Fax:908-504-3656
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025449225X00000X
NJ46TR00977500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist