Caruso, Kelly Shannon
Caruso, Kelly Shannon is an sole proprietor health care provider with primary practice located at 1100 Montour Rd , Loysville PA 17047-9200. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Caruso, Kelly Shannon can be contacted via phone (717) 789-3553.Contact Information
Primary practice address
1100 Montour Rd
Loysville PA 17047-9200
Phone: (717) 789-3553
Fax: (717) 789-3198
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS009531L | Pennsylvania |
Profile Details
| NPI number | 1629017322 |
|---|---|
| LBN Legal business name | Caruso, Kelly Shannon |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Jan 28th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629017322 | NPPES |
| Pennsylvania | MEDICAID | 0018455660004 |
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