Doctor Name: | MARK MICHAEL CARUSO |
NPI Number: | 1639466642 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MT200596 |
Business Practice Address: | 2 Reads Way Ste 201 New Castle, DE - 197201607 |
Business Phone Number: | 3027094709 |
Business Fax Number: | 3027094551 |
Mailing Address: | 2 Reads Way, Ste 201 NEW CASTLE |
State: | DE |
Postal Code: | 197201607 |
Phone Number: | 3027094709 |
Fax Number: | 3027094551 |
NPI Enumeration Date: | 06/29/2011 |
NPI Last Update Date: | 08/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | MT200596 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |