Provider Demographics
NPI:1386613149
Name:AUTERI, JOSEPH S (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:AUTERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CAPITAL WAY STE 356
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2521
Mailing Address - Country:US
Mailing Address - Phone:609-537-6000
Mailing Address - Fax:
Practice Address - Street 1:2 CAPITAL WAY STE 356
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534
Practice Address - Country:US
Practice Address - Phone:609-537-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431256208G00000X
FLME155247208G00000X
VA0101238653172A00000X
NJ25MA11594200208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022804990001Medicaid
PA110595OtherMEDICARE
VA010196647Medicaid
VA00W607M01Medicare ID - Type UnspecifiedVA. MEDICARE NUMBER
PA110595OtherMEDICARE
VA010196647Medicaid