Provider Demographics
NPI:1699887281
Name:CARUSO, THOMAS G (BC-HIS)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:G
Last Name:CARUSO
Suffix:
Gender:M
Credentials:BC-HIS
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 4
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14750-0004
Mailing Address - Country:US
Mailing Address - Phone:716-499-9109
Mailing Address - Fax:
Practice Address - Street 1:7760 ROUTE 417 E
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:NY
Practice Address - Zip Code:14715-9602
Practice Address - Country:US
Practice Address - Phone:585-648-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000007819237700000X
237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist