GINA SIRACUSANO


Address: 630 Mastic Rd Ste 4, Mastic Beach, NY 11951-1020
Phone: 6317041899

GINA SIRACUSANO (NPI# 1790384410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790384410
Entity Type Individual
Full Name GINA SIRACUSANO
Credential ATC, CES
Practice Address 630 Mastic Rd Ste 4
Mastic Beach
NY 11951-1020
Mailing Address Po Box 57
Moriches
NY 11955-0057
Practice Telephone 6317041899
Mailing Telephone 6317041899
Enumeration Date 2020-10-23
Last Update Date 2020-10-23
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2255A2300X Specialist/Technologist
Specialization: Athletic Trainer
002663-01 NY Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
205 Beaver Dam Rd, Brookhaven, NY 117199707 6317041899

Office Location

Street Address 630 MASTIC RD STE 4
City MASTIC BEACH
State NY
Zip Code 11951-1020

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1689173577 Diana Perreco Licensed Practical Nurse 47 Montauk Dr, Mastic Beach, NY 11951 2018-02-06
1366832321 Taylor Viggers Specialist/Technologist Tangier Smith Elementary School, 336 Blanco Drive, Mastic Beach, NY 11951 2015-01-29
1497159735 Fabiola Reid Counselor 834 A East Main Street, Center Moriches, NY 11951 2014-10-15
1548674906 Jacqueline D Searing Local Education Agency (LEA) 240 Mastic Beach Road, Mastic Beach, NY 11951 2014-06-13
1275890659 Shaquana Marie Williams Nurse's Aide 143 Huntington Dr, Mastic Beach, NY 11951 2012-04-23
1790912889 Mariann Cali Developmental Therapist 215 Laurelton Drive, Mastic Beach, NY 11951 2009-06-16
1225495518 Steven Zore Acupuncturist 279 Madison St, Mastic Beach, NY 11951-1003 2016-01-19
1386907566 Raven Guy Licensed Practical Nurse 530 Mastic Rd, Mastic Beach, NY 11951-1012 2012-06-21
1134429939 Natalie Beth Gieser Speech-Language Pathologist 338 Blanco Dr, Mastic Beach, NY 11951-1021 2010-10-26
1750690665 Anne Lee Savik Social Worker 336 Blanco Dr, Mastic Beach, NY 11951-1021 2010-09-28
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Taxonomy Information

Taxonomy Code 2255A2300X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Specialist/Technologist
Specialization Athletic Trainer

Taxonomy Definition

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1902860430 Jacqueline Anne Crytzer Specialist/Technologist 271 Jefferson Dr, Mastic Beach, NY 11951-2723 2006-04-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1639779309 Jonathan Edwards Specialist/Technologist 39 Monty St, Plattsburgh, NY 12901-3702 2020-10-30
1245830207 Skyler Lauren Cirillo Specialist/Technologist 1000 Hempstead Turnpike, Hempstead, NY 11549-0001 2020-10-29
1134728504 Corinne Edwards Specialist/Technologist 3606 Nutt Rd, Jamestown, NY 14701-9432 2020-10-18
1720687163 Theresa A Trump Specialist/Technologist 7 Mapleline Rd, Ballston Lake, NY 12019-1589 2020-10-17
1235738667 Erica Michalski Specialist/Technologist 157 Hillpine Rd, Cheektowaga, NY 14227-2261 2020-10-17
1396344743 Jared Russom Specialist/Technologist 13 Brookview Ave., Delmar, NY 12054 2020-10-17
1720686231 Leighann Buzzard Specialist/Technologist 277 Forbes Ave, Tonawanda, NY 14150-4705 2020-10-16
1861090367 Jake Savino Specialist/Technologist 185 Oak Ave, Staten Island, NY 10306-4002 2020-10-15
1992303572 Elise Fitzsimmons Specialist/Technologist 9 Laker Hall, Oswego, NY 13126 2020-10-15
1295333870 Olivia Sarkodie Arthur Specialist/Technologist 128 Forest Ave, Buffalo, NY 14213-1039 2020-10-15
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Competitor

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City MASTIC BEACH
Zip Code 11951

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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