Provider Demographics
NPI:1972847259
Name:PUGLISI, MONICA L (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:L
Last Name:PUGLISI
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 ECHO LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:NY
Mailing Address - Zip Code:13778-3227
Mailing Address - Country:US
Mailing Address - Phone:607-237-3180
Mailing Address - Fax:
Practice Address - Street 1:557 ECHO LAKE RD
Practice Address - Street 2:
Practice Address - City:GREENE
Practice Address - State:NY
Practice Address - Zip Code:13778-3227
Practice Address - Country:US
Practice Address - Phone:607-237-3180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017755225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist