Provider Demographics
NPI:1043856537
Name:PUGLISI, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PUGLISI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 N BAYBERRY PKWY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9808
Mailing Address - Country:US
Mailing Address - Phone:301-512-5047
Mailing Address - Fax:
Practice Address - Street 1:259 N BAYBERRY PKWY
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9808
Practice Address - Country:US
Practice Address - Phone:301-512-5047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA-3264225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant