Healthcare Provider Details

I. General information

NPI: 1558546127
Provider Name (Legal Business Name): PUGLIESE SPINE AND SPORTS INJURY ASSCOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 CENTRAL AVE
WESTFIELD NJ
07090-2564
US

IV. Provider business mailing address

767 CENTRAL AVE
WESTFIELD NJ
07090-2564
US

V. Phone/Fax

Practice location:
  • Phone: 908-654-3040
  • Fax: 908-654-9286
Mailing address:
  • Phone: 908-654-3040
  • Fax: 908-654-9286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberMC05950
License Number StateNJ

VIII. Authorized Official

Name: DR. ANTONIO PUGLIESE
Title or Position: OWNER/ CHIROPRACTOR
Credential: D.C.
Phone: 908-654-3040