Provider Demographics
NPI:1487773685
Name:CARUSO, NICHOLAS ANDREW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ANDREW
Last Name:CARUSO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 US ROUTE 5 S
Mailing Address - Street 2:
Mailing Address - City:FAIRLEE
Mailing Address - State:VT
Mailing Address - Zip Code:05045-9776
Mailing Address - Country:US
Mailing Address - Phone:518-339-4148
Mailing Address - Fax:
Practice Address - Street 1:8 MARKET ST
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-4407
Practice Address - Country:US
Practice Address - Phone:603-298-6671
Practice Address - Fax:603-298-6672
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist