Provider Demographics
NPI:1598453797
Name:CARUSO, BARBARA ELLEN (MSED)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELLEN
Last Name:CARUSO
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:E
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:5384 LEETE RD
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-1206
Mailing Address - Country:US
Mailing Address - Phone:716-860-1880
Mailing Address - Fax:
Practice Address - Street 1:424 LAKESIDE RD
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:NY
Practice Address - Zip Code:14006-9552
Practice Address - Country:US
Practice Address - Phone:716-472-1289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1859103174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist