Healthcare Provider Details

I. General information

NPI: 1891771358
Provider Name (Legal Business Name): JOSEPH ELMO CAUDA MD FACS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 01/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 SHREWSBURY AVE SUITE 210
SHREWSBURY NJ
07702-4179
US

IV. Provider business mailing address

655 SHREWSBURY AVE SUITE 210
SHREWSBURY NJ
07702-4179
US

V. Phone/Fax

Practice location:
  • Phone: 732-747-4744
  • Fax: 732-747-4751
Mailing address:
  • Phone: 732-747-4744
  • Fax: 732-747-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA41837
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number25MA41837
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: