=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356818835
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILEE SUSAN CAUTERUCCI PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2018
-----------------------------------------------------
Last Update Date | 09/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 225 N MAIN ST
-----------------------------------------------------
City | CAPE MAY COURT HOUSE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08210-2121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-463-2948
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 FEDERAL ST STE 200
-----------------------------------------------------
City | CAMDEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08103-1088
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 848-288-6935
-----------------------------------------------------
Fax | 732-790-0107
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 25MP00635200
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | MA060296
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | 25MP00635200
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------