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1124857826
FREDDIE BAUTISTA
ELIZABETH, NJ
NPI
1124857826
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner Psychiatric/Mental Health
(Licence: NJ 26NJ15087100)
Enumeration Date
2024-07-31
Last Update Date
2024-07-31
Business Address
FREDDIE BAUTISTA
220 W JERSEY ST APT 1B
ELIZABETH, NJ 07202-1314
Phone number: 908-230-8785
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Mailing Address
FREDDIE BAUTISTA
220 W JERSEY ST APT 1B
ELIZABETH, NJ 07202-1314
Phone number: 908-230-8785
Copy
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