Provider Demographics
NPI:1952406670
Name:BUTTIGHERI, JOSEPH ANDRE (DPM FACFAS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANDRE
Last Name:BUTTIGHERI
Suffix:
Gender:M
Credentials:DPM FACFAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:939 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-1870
Mailing Address - Country:US
Mailing Address - Phone:201-864-2484
Mailing Address - Fax:201-864-6460
Practice Address - Street 1:939 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047
Practice Address - Country:US
Practice Address - Phone:201-864-2484
Practice Address - Fax:201-864-6460
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00181700213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU26970Medicare UPIN
NJ544191Medicare PIN