Provider Demographics
NPI:1649394875
Name:PUGLIANO-MAURO, MELISSA ANGELA (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANGELA
Last Name:PUGLIANO-MAURO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4437 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2660
Mailing Address - Country:US
Mailing Address - Phone:412-213-3297
Mailing Address - Fax:
Practice Address - Street 1:2585 FREEPORT RD
Practice Address - Street 2:SUITE 240
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-1425
Practice Address - Country:US
Practice Address - Phone:412-784-7350
Practice Address - Fax:412-784-7351
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD440187207ND0101X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD440187OtherPA STATE
VT042-0011823OtherSTATE LICENSE
VT042-0011823OtherSTATE LICENSE