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Individual

MR. DEREK S. CARUSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, MSN, PMHNP-BC

Contact information

Practice address
28 BOX ST APT N219, BROOKLYN, NY 11222-5585
(929) 683-3320
(866) 275-8660
Mailing address
16 WILLIAMS BLVD APT 1D, LAKE GROVE, NY 11755-2413
(631) 747-8121
(866) 275-8660

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
086771
NY
1041C0700X
Clinical Social Worker
084067
NY
163WP0808X
Psychiatric/Mental Health Registered Nurse
744382
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F405069
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03482717
NY
01
1184445835
TYPE 2 NPI - ORGANIZATION
NY
01
13545756
CAQH ID #
NY
Enumeration date
08/28/2012
Last updated
11/24/2025
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