Provider Demographics
NPI:1437124252
Name:CARUSO, MICHAEL J (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:CARUSO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 STONE HARBOR BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2137
Mailing Address - Country:US
Mailing Address - Phone:609-465-1616
Mailing Address - Fax:606-465-3213
Practice Address - Street 1:207 STONE HARBOR BOULEVARD
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2137
Practice Address - Country:US
Practice Address - Phone:609-465-1616
Practice Address - Fax:606-465-3213
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05159600207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3566609Medicaid
NJAT005463Medicare ID - Type Unspecified
NJD19101Medicare UPIN
NJ457162L9QMedicare PIN
NJ3566609Medicaid