Healthcare Provider Details

I. General information

NPI: 1841295466
Provider Name (Legal Business Name): NICHOLAS P CARUSO JR. R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MOUNT ROYAL BLVD
PITTSBURGH PA
15223-1060
US

IV. Provider business mailing address

RR 1 BOX 17A1
FORD CITY PA
16226-9702
US

V. Phone/Fax

Practice location:
  • Phone: 412-487-5706
  • Fax:
Mailing address:
  • Phone: 412-860-3652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP438795
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: