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NPI Code Detail

MEDICARE: CATHERINE DELLORUSSO LMT

MEDICARE: CATHERINE DELLORUSSO LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist024183NY

General Provider Information

NPI Number : 1720734791
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE DELLORUSSO LMT
Provider Business Mailing Address
First Line : 11 REDWOOD CT
Second Line :
City : CORAM
State : NY
Zip : 11727-1519
Country : US
Telephone Number : 631-678-7518
Fax Number :
Provider Business Practice Location Address
First Line : 636 MIDDLE COUNTRY RD
Second Line :
City : SELDEN
State : NY
Zip : 11784-2500
Country : US
Telephone Number : 631-736-4414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2022
Last Update Date : 02/28/2022

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Directions to “ CATHERINE DELLORUSSO LMT” Practice Location

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