MEDICARE: MR. MATTHEW SAVERIO PUGLIESE PT

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	225100000X	Physical Therapist	030073	NY

General Provider Information

NPI Number	:	1881992410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW SAVERIO PUGLIESE PT

Provider Business Mailing Address
First Line	:	175 W 76TH ST APT 2F
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-8304
Country	:	US
Telephone Number	:	607-342-2979
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 W 76TH ST APT 2F
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-8304
Country	:	US
Telephone Number	:	607-342-2979
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2011
Last Update Date	:	04/20/2021

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