Provider Demographics
NPI:1366895021
Name:CARUSO, JOSEPH (MA PTA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:CARUSO
Suffix:
Gender:M
Credentials:MA PTA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:80 COUNTY ST
Mailing Address - Street 2:APT 2A
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5544
Mailing Address - Country:US
Mailing Address - Phone:315-796-4301
Mailing Address - Fax:
Practice Address - Street 1:493 HERITAGE RD
Practice Address - Street 2:SUITE 1C
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-3879
Practice Address - Country:US
Practice Address - Phone:203-586-1385
Practice Address - Fax:203-619-6680
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001538225200000X
NY8388422225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant