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Individual

LORIELLEN E LORUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.C., N.P.

Contact information

Practice address
5225 ROUTE 347 STE 70, PORT JEFFERSON STATION, NY 11776-2061
(631) 331-8777
(631) 474-9169
Mailing address
5225 ROUTE 347 STE 70, PORT JEFFERSON STATION, NY 11776-2061
(631) 331-8777
(631) 474-9169

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
499885
NY

Other

Enumeration date
06/12/2008
Last updated
06/12/2008
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