Individual
CORI MARIE SURERUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 TRIANGLE RD, LIBERTY, NY 12754-3368
(845) 747-2580
Mailing address
GERRI GELSOMINO, POBOX 923, FORESTBURGH, NY 12777
(845) 747-2580
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2583100
NY
Other
Enumeration date
07/27/2021
Last updated
09/22/2021
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