Healthcare Provider Details

I. General information

NPI: 1356818835
Provider Name (Legal Business Name): EMILEE SUSAN CAUTERUCCI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILEE RUTHERFORD

II. Dates (important events)

Enumeration Date: 11/01/2018
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N MAIN ST
CAPE MAY COURT HOUSE NJ
08210-2121
US

IV. Provider business mailing address

1 FEDERAL ST STE 200
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 609-463-2948
  • Fax:
Mailing address:
  • Phone: 848-288-6935
  • Fax: 732-790-0107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00635200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA060296
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number25MP00635200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: