Healthcare Provider Details

I. General information

NPI: 1902738875
Provider Name (Legal Business Name): MICHELE CELESTE SAUTNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 BOWDEN RD
CEDAR GROVE NJ
07009-1713
US

IV. Provider business mailing address

38 BOWDEN RD
CEDAR GROVE NJ
07009-1713
US

V. Phone/Fax

Practice location:
  • Phone: 973-477-3641
  • Fax:
Mailing address:
  • Phone: 973-477-3641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ15582100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: