Individual
MARY F LARUSSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5008 BRITTONFIELD PKWY, EAST SYRACUSE, NY 13057-9248
(315) 472-7504
(315) 479-8639
Mailing address
5008 BRITTONFIELD PKWY, EAST SYRACUSE, NY 13057-9248
(315) 472-7504
(315) 479-8639
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F334922
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02959222
—
NY
Enumeration date
10/27/2006
Last updated
12/04/2009
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