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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

GINA SIRACUSANO, ATC, CES

Active Sole Proprietor

GINA SIRACUSANO, ATC, CES is a Athletic Trainer healthcare provider located in MASTIC BEACH, New York. NPI 1790384410 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · MASTIC BEACH, NY

Registration Details

NPI Number
1790384410
Provider Type
Individual
Gender
Female
NPI Issued
Oct 23, 2020 (5.8306028656391 yrs)
Last Updated
Oct 23, 2020
License
002663-01 (NY)
Sole Proprietor
Yes

Practice Information

Address
630 MASTIC RD STE 4
MASTIC BEACH, NY, 119511020
Browse NY providers · Browse ZIP 11951
Phone
6317041899
Primary Specialty
Athletic Trainer
2255A2300X

Other Athletic Trainer Providers in MASTIC BEACH, NY

Name Credential NPI
MS. JACQUELINE ANNE CRYTZER ATC 1902860430
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.