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General NPI Number Information
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NPI Number | 1326287293
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Entity Type | Organization
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Legal Business Name | PATRICIA D. CARUSO,O.D.
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Dates
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Enumeration Date | 02/17/2009
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Last Update Date | 02/17/2009
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Provider Practice Location Address
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Address Line | 101 SANFORD FARMS SHOPPING CTR
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City | AMSTERDAM
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State | NY
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Zip | 12010-7535
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Country | US
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Telephone | 518-843-0189
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 455
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City | CLIFTON PARK
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State | NY
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Zip | 12065-0455
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Country | US
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Telephone | 518-877-8170
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. PATRICIA D CARUSO
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Credential | O.D.
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Telephone | 518-877-8170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T004887-1
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License Number State | NY
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