Healthcare Provider Details

I. General information

NPI: 1578830576
Provider Name (Legal Business Name): CARUSO PHYSICAL THERAPY AND NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2011
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1278 YARDVILLE ALLENTOWN RD
ALLENTOWN NJ
08501-1866
US

IV. Provider business mailing address

1278 YARDVILLE ALLENTOWN RD
ALLENTOWN NJ
08501-1866
US

V. Phone/Fax

Practice location:
  • Phone: 609-584-9594
  • Fax: 609-584-9594
Mailing address:
  • Phone: 609-584-9594
  • Fax: 609-584-9594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number261QP2000X
License Number StateNJ

VIII. Authorized Official

Name: OLIVIA ANN CARUSO
Title or Position: CEO/ OWNER
Credential: MA, RDN
Phone: 609-738-3143