Healthcare Provider Details

I. General information

NPI: 1114886421
Provider Name (Legal Business Name): AUTSOME CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2026
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 LONGVIEW CT
NORTHVALE NJ
07647-1316
US

IV. Provider business mailing address

407 LONGVIEW CT
NORTHVALE NJ
07647-1316
US

V. Phone/Fax

Practice location:
  • Phone: 914-409-8896
  • Fax: 914-409-8896
Mailing address:
  • Phone: 914-409-8896
  • Fax: 914-409-8896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BHARTI GHAI
Title or Position: CEO
Credential: GHAI
Phone: 914-409-8896