Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 243050 | NY |
NPI | 1225161284 |
---|---|
Provider Name | Dr. Gregory Puglisi |
First Address | Plainview, NY 11803-5022 |
Second Address | Plainview, NY 11803-5022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 19/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
243050 | LICENSE NUMBER (01) | NY |