1881653905 NPI number — MRS. ERICA D. PUGLIELLI N.P.

Table of content: MRS. ERICA D. PUGLIELLI N.P. (NPI 1881653905)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881653905 NPI number — MRS. ERICA D. PUGLIELLI N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PUGLIELLI
Provider First Name:
ERICA
Provider Middle Name:
D.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEE
Provider Other First Name:
ERICA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CFNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881653905
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
79 ERDMAN WAY
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
LEOMINSTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-537-4805
Provider Business Mailing Address Fax Number:
978-537-2185

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
79 ERDMAN WAY
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
LEOMINSTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-537-4805
Provider Business Practice Location Address Fax Number:
978-537-2185
Provider Enumeration Date:
03/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  233869 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: RN233869 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: RN233869 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 93059 . This is a "FALLON HP" identifier . This identifiers is of the category "OTHER".
  • Identifier: NP3941 . This is a "BCBS MA" identifier . This identifiers is of the category "OTHER".




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