Provider Demographics
NPI:1962637298
Name:CARUSO, SYLVIA HELEN
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:HELEN
Last Name:CARUSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BROADWAY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-1057
Mailing Address - Country:US
Mailing Address - Phone:781-233-9787
Mailing Address - Fax:781-842-3419
Practice Address - Street 1:5 BROADWAY
Practice Address - Street 2:SUITE 104
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-1057
Practice Address - Country:US
Practice Address - Phone:781-233-9787
Practice Address - Fax:781-842-3419
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1095043171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor