Provider Demographics
NPI:1043756760
Name:HALEY ELIZABETH CARUSO
Entity Type:Organization
Organization Name:HALEY ELIZABETH CARUSO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBENSCC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-486-7521
Mailing Address - Street 1:654 MADISON AVE
Mailing Address - Street 2:SUITE 709
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8438
Mailing Address - Country:US
Mailing Address - Phone:212-486-7521
Mailing Address - Fax:
Practice Address - Street 1:654 MADISON AVE
Practice Address - Street 2:SUITE 709
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8404
Practice Address - Country:US
Practice Address - Phone:212-486-7521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133641871OtherAUD