Provider Demographics
NPI:1124340724
Name:SIRAGUSA, GIUSEPPE
Entity type:Individual
Prefix:MR
First Name:GIUSEPPE
Middle Name:
Last Name:SIRAGUSA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2225
Mailing Address - Country:US
Mailing Address - Phone:516-594-7024
Mailing Address - Fax:516-594-7028
Practice Address - Street 1:2745 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2225
Practice Address - Country:US
Practice Address - Phone:516-594-7024
Practice Address - Fax:516-594-7028
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist