Healthcare Provider Details

I. General information

NPI: 1821268145
Provider Name (Legal Business Name): WENDY D CARUSO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 SAYBROOK RD
MIDDLETOWN CT
06457-4859
US

IV. Provider business mailing address

1290 SILAS DEANE HWY
WETHERSFIELD CT
06109-4337
US

V. Phone/Fax

Practice location:
  • Phone: 860-636-2010
  • Fax:
Mailing address:
  • Phone: 860-636-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number003486
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: