Provider Demographics
NPI:1477615540
Name:CARUSO, CHRISTINA M (MS RD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:M
Last Name:CARUSO
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:FALCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS RD
Mailing Address - Street 1:4 DODGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3204
Mailing Address - Country:US
Mailing Address - Phone:508-233-5153
Mailing Address - Fax:508-233-5833
Practice Address - Street 1:4 DODGE RD
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3204
Practice Address - Country:US
Practice Address - Phone:508-233-5153
Practice Address - Fax:508-233-5833
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered