Gina Siracusano, ATC, CES
NPI #1790384410 in Mastic Beach, New York
Provider Information
- NPI Number
- 1790384410
- Entity Type
- Individual
- Name
- Gina Siracusano, ATC, CES
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC, CES
- Enumeration Date
- Oct 23, 2020
- Last Updated
- Oct 23, 2020
Practice Location
- Address
- 630 MASTIC RD STE 4
- City
- Mastic Beach
- State
- New York
- ZIP Code
- 11951-1020
- Phone
- (631) 704-1899
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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