Provider Demographics
NPI:1285880195
Name:CARUSO, JENNIFER ANN (PSYD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:CARUSO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 TALCOTTVILLE RD STE 6
Mailing Address - Street 2:HARTFORD HOSPITAL MOVEMENT DISORDERS CENTER
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-5261
Mailing Address - Country:US
Mailing Address - Phone:860-870-6385
Mailing Address - Fax:
Practice Address - Street 1:35 TALCOTTVILLE RD STE 6
Practice Address - Street 2:HARTFORD HOSPITAL MOVEMENT DISORDERS CENTER
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-5261
Practice Address - Country:US
Practice Address - Phone:860-870-6385
Practice Address - Fax:860-870-0622
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002847103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist