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General NPI Number Information
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NPI Number | 1629037734
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Entity Type | Individual
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Provider Name | JOANNE CARUSO OD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 02/17/2009
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Provider Practice Location Address
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Address Line | 235 WAVERLY AVE
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City | WATERTOWN
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State | MA
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Zip | 02472-3238
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Country | US
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Telephone | 617-926-4191
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Fax | 617-926-4090
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Provider Business Mailing Address
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Address Line | 235 WAVERLY AVE
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City | WATERTOWN
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State | MA
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Zip | 02472-3238
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Country | US
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Telephone | 617-926-4191
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Fax | 617-926-4090
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3209
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License Number State | MA
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