Provider Demographics
NPI:1811180094
Name:PUGLISI, RENEE E (CTRS, CBIS)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:E
Last Name:PUGLISI
Suffix:
Gender:F
Credentials:CTRS, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3129
Mailing Address - Country:US
Mailing Address - Phone:908-419-9484
Mailing Address - Fax:
Practice Address - Street 1:17 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-3129
Practice Address - Country:US
Practice Address - Phone:908-419-9484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJCERT # 51920225800000X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist