Provider Demographics
NPI:1760655369
Name:CARUSO, ROSE A (DPM)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:A
Last Name:CARUSO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 THOREAU DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-4329
Mailing Address - Country:US
Mailing Address - Phone:732-366-9866
Mailing Address - Fax:732-866-0006
Practice Address - Street 1:38 THOREAU DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-4329
Practice Address - Country:US
Practice Address - Phone:732-366-9866
Practice Address - Fax:732-866-0006
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005902213E00000X
NJMD002962213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist