Provider Demographics
NPI:1437552072
Name:PUGLIA, LINDA ANTOINETTA (L-CSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANTOINETTA
Last Name:PUGLIA
Suffix:
Gender:F
Credentials:L-CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10918-1324
Mailing Address - Country:US
Mailing Address - Phone:845-469-2270
Mailing Address - Fax:845-469-1810
Practice Address - Street 1:3 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10918-1324
Practice Address - Country:US
Practice Address - Phone:845-469-2270
Practice Address - Fax:845-469-1810
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073553-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical