Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 10666 | CT |
NPI | 1003284712 |
---|---|
Provider Name | Toni Caruso |
First Address | Buffalo, NY 14225-4408 |
Second Address | Buffalo, NY 14225-4408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2015 |
Last Update Date | 11/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10666 | INDEPENDENT HEALTH (01) | CT |