MEDICARE: PUGLIESE SPINE AND SPORTS INJURY ASSCOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	MC05950	NJ

General Provider Information

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

Provider Business Mailing Address
First Line	:	767 CENTRAL AVE
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-2564
Country	:	US
Telephone Number	:	908-654-3040
Fax Number	:	908-654-9286

Provider Business Practice Location Address
First Line	:	767 CENTRAL AVE
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-2564
Country	:	US
Telephone Number	:	908-654-3040
Fax Number	:	908-654-9286

Authorized Official
Title or Position	:	OWNER/ CHIROPRACTOR
Name	:	DR. ANTONIO PUGLIESE
Credential	:	D.C.
Telephone Number	:	908-654-3040

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	12/17/2025

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