Provider Demographics
NPI:1619061934
Name:DELLORUSSO, GIUSEPPE (MD)
Entity Type:Individual
Prefix:DR
First Name:GIUSEPPE
Middle Name:
Last Name:DELLORUSSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1929
Mailing Address - Country:US
Mailing Address - Phone:516-599-7353
Mailing Address - Fax:516-599-7325
Practice Address - Street 1:58 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1929
Practice Address - Country:US
Practice Address - Phone:516-599-7353
Practice Address - Fax:516-599-7325
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185239208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics