Healthcare Provider Details

I. General information

NPI: 1578661559
Provider Name (Legal Business Name): PATRICK D PUGLIESE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 HOSPITAL RD EMERGENCY DEPARTMENT
COAL TOWNSHIP PA
17866-9668
US

IV. Provider business mailing address

38935 ANN ARBOR RD
LIVONIA MI
48150-3397
US

V. Phone/Fax

Practice location:
  • Phone: 570-644-4222
  • Fax:
Mailing address:
  • Phone: 734-805-0488
  • Fax: 866-250-6385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD029341E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: