Provider Demographics
NPI:1053640888
Name:CARUSO, ERIN MARIE (APN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:CARUSO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MARIE
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:151 FRIES MILL RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2016
Mailing Address - Country:US
Mailing Address - Phone:856-513-4124
Mailing Address - Fax:
Practice Address - Street 1:435 HURFFVILLE CROSS KEYS RD
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2453
Practice Address - Country:US
Practice Address - Phone:856-513-4124
Practice Address - Fax:856-302-5932
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00269000363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0225690Medicaid
NJ389347ZGH1Medicare PIN