Phillip Caruso, LPC | |
268 Green Village Rd, Green Village, NJ 07935-3027 | |
(201) 274-5594 | |
Not Available |
Full Name | Phillip Caruso |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 268 Green Village Rd, Green Village, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245768977 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 37PC00441500 (New Jersey) | Primary |
Entity Name | Lifebulb Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699491464 PECOS PAC ID: 2062881162 Enrollment ID: O20230301003017 |
Mailing Address | Practice Location Address |
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Phillip Caruso, LPC 549 Route 10 Apt 2, Whippany, NJ 07981-1552 Ph: (201) 274-5594 | Phillip Caruso, LPC 268 Green Village Rd, Green Village, NJ 07935-3027 Ph: (201) 274-5594 |
Ms. Ellen M Purtell, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 268 Green Village Rd Ste 21, Green Village, NJ 07935 Phone: 973-615-7037 | |
Ashley Janosko, Counselor Medicare: Not Enrolled in Medicare Practice Location: 268 Green Village Rd, Green Village, NJ 07935 Phone: 570-872-7693 | |
Mrs. Kelly Medvin, LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 268 Green Village Rd, Green Village, NJ 07935 Phone: 917-922-1693 |