Individual
MR. NICHOLAS MATTHEW USURIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
23 ROMODA DR, CANTON, NY 13617-1423
(315) 229-1843
Mailing address
22 BUCK ST APT 2, CANTON, NY 13617-1395
(845) 596-8226
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004010
NY
Other
Enumeration date
11/11/2019
Last updated
11/11/2019
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