Provider Demographics
NPI:1114546793
Name:AUSTERO, THROY JEFFREY (DPM)
Entity Type:Individual
Prefix:
First Name:THROY
Middle Name:JEFFREY
Last Name:AUSTERO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 ADAMS ST STE DE
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2370
Mailing Address - Country:US
Mailing Address - Phone:201-308-6622
Mailing Address - Fax:201-308-6623
Practice Address - Street 1:1320 ADAMS ST STE DE
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2370
Practice Address - Country:US
Practice Address - Phone:201-308-6622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN007365213E00000X
NJ25MD00375500213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist