Healthcare Provider Details

I. General information

NPI: 1023076965
Provider Name (Legal Business Name): GEORGE PETER CAUTILLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 LANGHORNE NEWTOWN RD STE 120
LANGHORNE PA
19047-1211
US

IV. Provider business mailing address

41 UNIVERSITY DR STE 300
NEWTOWN PA
18940-1873
US

V. Phone/Fax

Practice location:
  • Phone: 267-364-9100
  • Fax: 267-364-9101
Mailing address:
  • Phone: 215-710-5522
  • Fax: 157-105-1812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD039658E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: