Healthcare Provider Details

I. General information

NPI: 1760562276
Provider Name (Legal Business Name): CHERRY HILL TOTAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MARLTON PIKE E SUITE 20
CHERRY HILL NJ
08034-2207
US

IV. Provider business mailing address

200 STATE ROUTE 34 N
COLTS NECK NJ
07722-1234
US

V. Phone/Fax

Practice location:
  • Phone: 856-216-1020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number611200
License Number StateNJ

VIII. Authorized Official

Name: DR. GIULIO CARUSO
Title or Position: OWNER
Credential: DC
Phone: 732-332-9000