Provider Demographics
NPI:1417420191
Name:PUGLIESE, JOSEPH JULIUS (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JULIUS
Last Name:PUGLIESE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 EGAN AVE
Mailing Address - Street 2:
Mailing Address - City:FORDS
Mailing Address - State:NJ
Mailing Address - Zip Code:08863-1911
Mailing Address - Country:US
Mailing Address - Phone:732-738-5885
Mailing Address - Fax:
Practice Address - Street 1:6 EGAN AVE
Practice Address - Street 2:
Practice Address - City:FORDS
Practice Address - State:NJ
Practice Address - Zip Code:08863-1911
Practice Address - Country:US
Practice Address - Phone:732-656-0743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-06
Last Update Date:2019-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01701000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist