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Individual

MR. MICHAEL JAMES CARUSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
658 MALTA AVE, STE 101, MALTA, NY 12020
(518) 580-0553
(518) 580-0557
Mailing address
658 MALTA AVE, STE 101, MALTA, NY 12020
(518) 580-0553
(518) 580-0557

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008849
NY
390200000X
Student in an Organized Health Care Education/Training Program
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03425445
NY
Enumeration date
06/06/2018
Last updated
08/25/2023
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