Provider Demographics
NPI:1023076965
Name:CAUTILLI, GEORGE PETER (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:PETER
Last Name:CAUTILLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-5522
Mailing Address - Fax:157-105-1812
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD STE 120
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1211
Practice Address - Country:US
Practice Address - Phone:267-364-9100
Practice Address - Fax:267-364-9101
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039658E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
200045766OtherRAILROAD MEDICARE
8110497004OtherCIGNA
PA0012740190003Medicaid
693919OtherBLUE CHOICE
PA0012740190002Medicaid
2981921OtherAETNA NUMBERS
693919OtherPERSONAL CHOICE NUMBERS
PA0012740190001Medicaid
0528886000OtherKEYSTONE HEALTHPLAN EAST
693919OtherPA BLUE SHIELD GROUP
PA0012740190003Medicaid