Provider Demographics
NPI:1679080543
Name:CARUSO, HANNAH (L AC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:CARUSO
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 FELICELLO DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-5608
Mailing Address - Country:US
Mailing Address - Phone:845-430-1309
Mailing Address - Fax:
Practice Address - Street 1:243 MAIN ST STE 240
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1354
Practice Address - Country:US
Practice Address - Phone:845-430-1309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-02
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006146-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist