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General NPI Number Information
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NPI Number | 1518964907
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Entity Type | Individual
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Provider Name | CATHERINE TERESA CARUSO
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Gender | Female
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 05/12/2015
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Provider Practice Location Address
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Address Line | 203 PARK VISTA TERRACE
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City | ALLENTOWN
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State | PA
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Zip | 18104
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Country | US
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Telephone | 610-703-7244
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Fax |
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Provider Business Mailing Address
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Address Line | 1641 RED PINE LANE
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City | EFFORT
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State | PA
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Zip | 18330-9103
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Country | US
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Telephone | 610-554-6104
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | UP006315H
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License Number State | PA
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