Provider Demographics
NPI:1295515831
Name:PUGLIA, DIANA KATHLEEN (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:KATHLEEN
Last Name:PUGLIA
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 EALEY CT
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-3016
Mailing Address - Country:US
Mailing Address - Phone:856-974-3411
Mailing Address - Fax:
Practice Address - Street 1:21 EALEY CT
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-3016
Practice Address - Country:US
Practice Address - Phone:856-974-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJL-310864163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant