Provider Demographics
NPI:1821093436
Name:CARUSO, MEGHAN MURPHY SCHMELZER (DO)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:MURPHY SCHMELZER
Last Name:CARUSO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9002 LINCOLN DR W
Mailing Address - Street 2:STE D
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3204
Mailing Address - Country:US
Mailing Address - Phone:856-983-4646
Mailing Address - Fax:856-986-4760
Practice Address - Street 1:9002 LINCOLN DR W
Practice Address - Street 2:STE D
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3204
Practice Address - Country:US
Practice Address - Phone:856-983-4646
Practice Address - Fax:856-986-4760
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB06858000207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8656509Medicaid
NJH07666Medicare UPIN
NJ8656509Medicaid