MEDICARE: ROCCHINA PUGLIESE RPA-C

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	363AM0700X	Medical Physician Assistant	012670	NY

General Provider Information

NPI Number	:	1922259365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROCCHINA PUGLIESE RPA-C

Provider Business Mailing Address
First Line	:	7 BONTECOU RD
Second Line	:
City	:	STONY POINT
State	:	NY
Zip	:	10980-2601
Country	:	US
Telephone Number	:	347-414-4004
Fax Number	:

Provider Business Practice Location Address
First Line	:	1624 CROSBY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5201
Country	:	US
Telephone Number	:	718-822-2138
Fax Number	:

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

Provider Enumeration Date	:	10/03/2008
Last Update Date	:	09/30/2010

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