Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gina Siracusano, ATC, CES

Individual provider Athletic Trainer · NPI 1790384410

Gina Siracusano, ATC, CES is an Athletic Trainer in Mastic Beach, New York. Practices as a sole proprietor and works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2020
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

630 Mastic Rd Ste 4
Mastic Beach, NY 11951-1020
Phone: (631) 704-1899
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 205 Beaver Dam Rd, Brookhaven, NY 11719-9707 — (631) 704-1899

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 002663-01 (NY)

Record details

NPI number1790384410
Entity typeIndividual (Type 1)
GenderFemale
Credentials ATC , CES
Sole proprietorYes
NPI enumeratedOctober 23, 2020
Last updated in NPPESOctober 23, 2020
Certification dateOctober 23, 2020

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