Individual
JACOB CHARLES PUGLISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9226
Mailing address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9226
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003638
VA
363AM0700X
Medical Physician Assistant
0110003638
VA
Other
Enumeration date
03/31/2006
Last updated
01/02/2025
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