Provider Demographics
NPI:1699981126
Name:PUGLISI, JO ANN GONZALES (PT)
Entity type:Individual
Prefix:MS
First Name:JO ANN
Middle Name:GONZALES
Last Name:PUGLISI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:259 INDIAN RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4915
Mailing Address - Country:US
Mailing Address - Phone:973-568-1229
Mailing Address - Fax:
Practice Address - Street 1:88 MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1412
Practice Address - Country:US
Practice Address - Phone:877-887-3574
Practice Address - Fax:973-595-8465
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025729-1225100000X
NJ40QA01237800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist