Healthcare Provider Details

I. General information

NPI: 1710991286
Provider Name (Legal Business Name): MATTHEW JOHN PUGLIA MSPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 N MAIN ST
BELLINGHAM MA
02019
US

IV. Provider business mailing address

667 HAVERHILL ST
READING MA
01867
US

V. Phone/Fax

Practice location:
  • Phone: 508-966-2717
  • Fax: 508-966-2095
Mailing address:
  • Phone: 781-942-1103
  • Fax: 508-966-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: