Provider Demographics
NPI:1205884475
Name:CARUSO, CHRISTIAN D (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:D
Last Name:CARUSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 NARTOFF RD
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NH
Mailing Address - Zip Code:03049-5903
Mailing Address - Country:US
Mailing Address - Phone:617-376-5784
Mailing Address - Fax:
Practice Address - Street 1:114 WHITWELL STREET
Practice Address - Street 2:QUINCY MEDICAL CENTER
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169
Practice Address - Country:US
Practice Address - Phone:617-376-5784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208007208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist