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NPI Code Detail

MEDICARE: SAMANTHA GWYNNE CARUSO PSYD

MEDICARE: SAMANTHA GWYNNE CARUSO PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist017452NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831390855
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA GWYNNE CARUSO PSYD
Provider Business Mailing Address
First Line : 9 CAREY RD
Second Line :
City : QUEENSBURY
State : NY
Zip : 12804-7880
Country : US
Telephone Number : 518-761-0300
Fax Number :
Provider Business Practice Location Address
First Line : 161 CAREY RD
Second Line :
City : QUEENSBURY
State : NY
Zip : 12804-7821
Country : US
Telephone Number : 518-824-8610
Fax Number : 518-824-2390
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2007
Last Update Date : 03/12/2026

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