Provider Demographics
NPI:1114475431
Name:CARUSO, PAUL D (NBC-HIS, BS)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:D
Last Name:CARUSO
Suffix:
Gender:M
Credentials:NBC-HIS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 BERKLEY MANOR DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-8103
Mailing Address - Country:US
Mailing Address - Phone:724-513-5453
Mailing Address - Fax:
Practice Address - Street 1:2000 VILLAGE CENTER DR
Practice Address - Street 2:
Practice Address - City:TARENTUM
Practice Address - State:PA
Practice Address - Zip Code:15084-3844
Practice Address - Country:US
Practice Address - Phone:724-715-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03126237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist