Individual
NICHOLAS A CANUSO JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10455 LINCOLN HWY, EVERETT, PA 15537-7046
(814) 623-3524
(814) 623-0646
Mailing address
10455 LINCOLN HWY, EVERETT, PA 15537-7046
(814) 623-3524
(814) 623-0646
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD018020L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008288380017
—
PA
Enumeration date
08/23/2005
Last updated
07/08/2007
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