Provider Demographics
NPI:1487631875
Name:CARUSO, LAUREN S (PHD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:S
Last Name:CARUSO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E 79TH ST
Mailing Address - Street 2:SUITE 8A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0847
Mailing Address - Country:US
Mailing Address - Phone:212-717-2711
Mailing Address - Fax:914-946-1527
Practice Address - Street 1:244 WESTCHESTER AVE
Practice Address - Street 2:SUITE 315
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2907
Practice Address - Country:US
Practice Address - Phone:212-717-2711
Practice Address - Fax:914-946-1527
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012539103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV05321Medicare ID - Type Unspecified