Individual
DOMINIC LORUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
27 WASHINGTON PL, ROOSEVELT, NY 11575-1435
(516) 623-7741
Mailing address
27 WASHINGTON PL, ROOSEVELT, NY 11575-1435
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
792449
NY
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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