Provider Demographics
NPI:1275016453
Name:CARUSO, DANA JEANNE (RN)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:JEANNE
Last Name:CARUSO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LAKE WALTON RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-6309
Mailing Address - Country:US
Mailing Address - Phone:845-227-1770
Mailing Address - Fax:845-227-1782
Practice Address - Street 1:17 LAKE WALTON RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6309
Practice Address - Country:US
Practice Address - Phone:845-227-1770
Practice Address - Fax:845-227-1782
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY736516-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool