Provider Demographics
NPI:1932168465
Name:CARUSO, SCOTT M (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:M
Last Name:CARUSO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 775
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:PA
Mailing Address - Zip Code:15051-0775
Mailing Address - Country:US
Mailing Address - Phone:412-767-5650
Mailing Address - Fax:
Practice Address - Street 1:897 ROUTE 910
Practice Address - Street 2:SUITE 103
Practice Address - City:INDIANOLA
Practice Address - State:PA
Practice Address - Zip Code:15051-1003
Practice Address - Country:US
Practice Address - Phone:412-767-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007220L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021100OtherASH NETWORK
PA035523OtherHIGHMARK BCBS
PAU72300Medicare UPIN
PA035523OtherHIGHMARK BCBS