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Individual

JENNA LORUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4893 TRANSIT RD, DEPEW, NY 14043-4698
(716) 608-7040
Mailing address
78 KENNEDY CT, LANCASTER, NY 14086-1242
(716) 989-7016

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
024587
NY

Other

Enumeration date
01/08/2020
Last updated
02/19/2020
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