Provider Demographics
NPI:1033404660
Name:CARUSO, MARY PIEKARSKI (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:PIEKARSKI
Last Name:CARUSO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:PIEKARSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:900 E KEMPER RD
Mailing Address - Street 2:T1037
Mailing Address - City:SPRINGDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45246-2518
Mailing Address - Country:US
Mailing Address - Phone:513-671-8603
Mailing Address - Fax:513-671-8603
Practice Address - Street 1:900 E KEMPER RD
Practice Address - Street 2:T1037
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-2518
Practice Address - Country:US
Practice Address - Phone:513-671-8603
Practice Address - Fax:513-671-8603
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03321897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist