=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780658864
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EDWARD FRANCIS CARUSO MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/15/2006
-----------------------------------------------------
Last Update Date | 08/27/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 960 ROUTE 173
-----------------------------------------------------
City | BLOOMSBURY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08804-3112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-388-3500
-----------------------------------------------------
Fax | 908-388-3501
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 137
-----------------------------------------------------
City | STEWARTSVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08886
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-454-6749
-----------------------------------------------------
Fax | 908-454-4449
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 25MA07179100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0805X
-----------------------------------------------------
Taxonomy Name | Geriatric Psychiatry Physician
-----------------------------------------------------
License Number | 25MA07179100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------