Healthcare Provider Details

I. General information

NPI: 1801898143
Provider Name (Legal Business Name): ANTHONY M CARISTO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 03/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 CHRISTIANA RD STE 105
NEWARK DE
19713-2067
US

IV. Provider business mailing address

774 CHRISTIANA RD STE 105
NEWARK DE
19713-2067
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-4250
  • Fax: 302-623-4252
Mailing address:
  • Phone: 302-623-4250
  • Fax: 302-623-4252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE10000137
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: