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General NPI Number Information
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NPI Number | 1447328778
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Entity Type | Individual
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Provider Name | SHAUNY LYNN CARUSO ATC
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Gender | Female
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | GOERGEN ATHLETIC CENTER UNIVERSITY OF ROCHESTER
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City | ROCHESTER
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State | NY
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Zip | 14627
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Country | US
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Telephone | 585-275-4890
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Fax | 585-461-5081
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Provider Business Mailing Address
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Address Line | 112 POND VIEW HTS
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City | ROCHESTER
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State | NY
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Zip | 14612-1308
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Country | US
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Telephone | 586-703-4498
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 001340
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License Number State | NY
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