Healthcare Provider Details

I. General information

NPI: 1053640888
Provider Name (Legal Business Name): ERIN MARIE CARUSO APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERIN MARIE SULLIVAN APN

II. Dates (important events)

Enumeration Date: 12/07/2009
Last Update Date: 01/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 HURFFVILLE CROSS KEYS RD
TURNERSVILLE NJ
08012-2453
US

IV. Provider business mailing address

151 FRIES MILL RD SUITE 301
TURNERSVILLE NJ
08012-2016
US

V. Phone/Fax

Practice location:
  • Phone: 856-513-4124
  • Fax: 856-302-5932
Mailing address:
  • Phone: 856-513-4124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ00269000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: