Provider Demographics
NPI:1255672440
Name:PUGLIESE, ROBERT RICHARD (MSN, APRN, FNP, NP-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RICHARD
Last Name:PUGLIESE
Suffix:
Gender:M
Credentials:MSN, APRN, FNP, NP-C
Other - Prefix:MR
Other - First Name:NORBERTO
Other - Middle Name:B
Other - Last Name:TORRES
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, FNP, NP-C
Mailing Address - Street 1:90 CHICORY DRIVE
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716
Mailing Address - Country:US
Mailing Address - Phone:203-233-2438
Mailing Address - Fax:203-879-0791
Practice Address - Street 1:90 CHICORY DR
Practice Address - Street 2:
Practice Address - City:WOLCOTT
Practice Address - State:CT
Practice Address - Zip Code:06716-1806
Practice Address - Country:US
Practice Address - Phone:203-233-2438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily