Basic Information
| Provider Information | |||||||||
| NPI: | 1518386390 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PUGLIESE | ||||||||
| FirstName: | MAURIZIO | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 202 S PARK ST | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537151596 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6084173886 | ||||||||
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| Practice Location | |||||||||
| Address1: | MERITER HOSPITAL, INC | ||||||||
| Address2: | 8102 WELLNESS WAY | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6084178777 | ||||||||
| FaxNumber: | 6084178757 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2014 | ||||||||
| LastUpdateDate: | 05/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 02005697A | IN | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 65371-21 | WI | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.