Provider Demographics
NPI:1285648782
Name:CARUSO, ANTHONY M (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:M
Last Name:CARUSO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2577 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:TONAWADA
Mailing Address - State:NY
Mailing Address - Zip Code:14150
Mailing Address - Country:US
Mailing Address - Phone:716-832-8888
Mailing Address - Fax:716-832-0124
Practice Address - Street 1:2577 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:TONAWADA
Practice Address - State:NY
Practice Address - Zip Code:14150
Practice Address - Country:US
Practice Address - Phone:716-832-8888
Practice Address - Fax:716-832-0124
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T86349Medicare UPIN
NY252071Medicare ID - Type Unspecified