Individual
MS. ADRIENNE MARIE LAVACCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3657 ROANOKE ST, SEAFORD, NY 11783-3055
(516) 679-5096
Mailing address
3657 ROANOKE ST, SEAFORD, NY 11783-3055
(516) 679-5096
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000590-1
NY
Other
Enumeration date
09/06/2014
Last updated
09/06/2014
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