Individual
MR. ROBERT ANTHONY BORRUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
1 FALCON PL, DEER PARK, NY 11729-3205
(631) 835-2962
Mailing address
285 AVE B, LAKE RONKONKOMA, NY 11779
(631) 580-0026
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001812-1
NY
Other
Enumeration date
06/20/2012
Last updated
07/19/2012
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