Provider Demographics
NPI:1811485303
Name:PUGLISI, ANTHONY (DC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:PUGLISI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 STONY BAR RD
Mailing Address - Street 2:
Mailing Address - City:SLATE HILL
Mailing Address - State:NY
Mailing Address - Zip Code:10973-4420
Mailing Address - Country:US
Mailing Address - Phone:845-551-0395
Mailing Address - Fax:
Practice Address - Street 1:157 STONY BAR RD
Practice Address - Street 2:
Practice Address - City:SLATE HILL
Practice Address - State:NY
Practice Address - Zip Code:10973-4420
Practice Address - Country:US
Practice Address - Phone:845-551-0395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013094111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty