Organization
DONATO R CARUSI, M. D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONATO R CARUSI M. D. (PROPRIETOR)
(814) 535-7661
Entity
Organization
Contact information
Practice address
321 MAIN ST, SUITE 4B, JOHNSTOWN, PA 15901-1632
(814) 535-7661
(814) 535-3106
Mailing address
321 MAIN ST, SUITE 4B, JOHNSTOWN, PA 15901-1632
(814) 535-7661
(814) 535-3106
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
MD036849E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010592090002
—
PA
Enumeration date
01/16/2008
Last updated
01/18/2008
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