Provider Demographics
NPI:1881297752
Name:CARUSO, RICHELLE COOK (RPH)
Entity type:Individual
Prefix:
First Name:RICHELLE
Middle Name:COOK
Last Name:CARUSO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ELLSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-7127
Mailing Address - Country:US
Mailing Address - Phone:937-369-6290
Mailing Address - Fax:
Practice Address - Street 1:334 STATE ROUTE 31
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5770
Practice Address - Country:US
Practice Address - Phone:908-782-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03437400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist