Provider Demographics
NPI:1285359588
Name:CARUSILLO, BARBARA JANE (PT, OCS, COMT)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JANE
Last Name:CARUSILLO
Suffix:
Gender:F
Credentials:PT, OCS, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7821 CLARENDON RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-3512
Mailing Address - Country:US
Mailing Address - Phone:317-443-1947
Mailing Address - Fax:
Practice Address - Street 1:7821 CLARENDON RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-3512
Practice Address - Country:US
Practice Address - Phone:317-443-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05001277A2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty