Healthcare Provider Details
I. General information
NPI: 1598840654
Provider Name (Legal Business Name): WILLIAM F PUGLISI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/26/2006
Last Update Date: 11/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35 FRANKLIN PL
TOTOWA NJ
07512-2604
US
IV. Provider business mailing address
35 FRANKLIN PL
TOTOWA NJ
07512-2604
US
V. Phone/Fax
- Phone: 973-980-1269
- Fax: 908-933-0379
- Phone: 973-980-1269
- Fax: 908-933-0379
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | MC2474 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: