Healthcare Provider Details

I. General information

NPI: 1437690914
Provider Name (Legal Business Name): NATALIE K CARUSO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATALIE K GENGEL DO

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 NURSERY ST STE 102
FOGELSVILLE PA
18051-1612
US

IV. Provider business mailing address

PO BOX 191
ROCKLAND DE
19732-0191
US

V. Phone/Fax

Practice location:
  • Phone: 610-336-8277
  • Fax:
Mailing address:
  • Phone: 602-651-4200
  • Fax: 302-651-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS019172
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number25MB10030800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: