Provider Demographics
NPI:1811041213
Name:SPORTSFOCUS PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:SPORTSFOCUS PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUGLIESE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:716-332-4838
Mailing Address - Street 1:531 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1450
Mailing Address - Country:US
Mailing Address - Phone:716-332-4838
Mailing Address - Fax:888-732-3062
Practice Address - Street 1:531 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1450
Practice Address - Country:US
Practice Address - Phone:716-332-4838
Practice Address - Fax:888-732-3062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy