Individual
GABRIELLE LORUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. ATC
Contact information
Practice address
6533 BURKE RD, LAKE VIEW, NY 14085-9733
(716) 430-1164
Mailing address
6533 BURKE RD, LAKE VIEW, NY 14085-9733
(716) 430-1164
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002404
NY
Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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