Individual
DR. LAWRENCE ERICK LARUSSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
650 PRE EMPTON RD, GENEVA, NY 14456-1334
(315) 789-8132
(315) 789-8136
Mailing address
650 PRE EMPTON RD, GENEVA, NY 14456-1334
(315) 789-8132
(315) 789-8136
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
SC006477
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SN00681
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04500643
—
NY
01
—
SC006477
PENNSYLVANIA STATE PODIATRIC MEDICAL LISCENSE NUMBER
PA
Enumeration date
06/26/2013
Last updated
05/09/2022
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