MEDICARE: MS. KAREN MARIE CARUSO FNP-C

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
1	363LF0000X	Family Nurse Practitioner	338749	NY
2	363LF0000X	Family Nurse Practitioner	F338749-1	NY

General Provider Information

NPI Number	:	1881008712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN MARIE CARUSO FNP-C

Provider Business Mailing Address
First Line	:	1729 BURRSTONE RD
Second Line	:
City	:	NEW HARTFORD
State	:	NY
Zip	:	13413-1001
Country	:	US
Telephone Number	:	315-798-1400
Fax Number	:	315-798-1407

Provider Business Practice Location Address
First Line	:	56 MONTGOMERY ST
Second Line	:
City	:	CANAJOHARIE
State	:	NY
Zip	:	13317-1212
Country	:	US
Telephone Number	:	518-673-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2014
Last Update Date	:	12/09/2017

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