Provider Demographics
NPI:1902188873
Name:HERNANDEZ CARUSO, SONIA (DO)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:HERNANDEZ CARUSO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SONIA
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:229 HALES MILLS RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-3743
Mailing Address - Country:US
Mailing Address - Phone:214-471-3597
Mailing Address - Fax:
Practice Address - Street 1:229 HALES MILLS RD
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-3743
Practice Address - Country:US
Practice Address - Phone:214-471-3597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1699-12208D00000X, 207W00000X
NY251522208D00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice