Provider Demographics
NPI:1407962590
Name:LORUSSO, WILLIAM A (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:LORUSSO
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Gender:M
Credentials:RPA-C
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Mailing Address - Street 1:151 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1000
Mailing Address - Country:US
Mailing Address - Phone:516-747-6176
Mailing Address - Fax:516-877-2076
Practice Address - Street 1:101 SAINT ANDREWS LN
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2254
Practice Address - Country:US
Practice Address - Phone:516-674-7591
Practice Address - Fax:516-674-1778
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY000744-1363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical