Healthcare Provider Details

I. General information

NPI: 1023000759
Provider Name (Legal Business Name): RICHARD F CARUSO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 SAVANNAH RD STE B
LEWES DE
19958-1514
US

IV. Provider business mailing address

PO BOX 472
LEWES DE
19958-0472
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-6698
  • Fax: 305-645-4505
Mailing address:
  • Phone: 302-645-6698
  • Fax: 302-645-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD F CARUSO
Title or Position: PRESIDENT
Credential: MD
Phone: 302-645-6698