Healthcare Provider Details

I. General information

NPI: 1780658864
Provider Name (Legal Business Name): EDWARD FRANCIS CARUSO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 ROUTE 173
BLOOMSBURY NJ
08804-3112
US

IV. Provider business mailing address

PO BOX 137
STEWARTSVILLE NJ
08886
US

V. Phone/Fax

Practice location:
  • Phone: 908-388-3500
  • Fax: 908-388-3501
Mailing address:
  • Phone: 908-454-6749
  • Fax: 908-454-4449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA07179100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number25MA07179100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: