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1215060090
MICHAEL B BAUTISTA
FLUSHING, NY
NPI
1215060090
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 005701)
Enumeration Date
2007-03-13
Last Update Date
2022-12-27
Business Address
Mr. MICHAEL B BAUTISTA PA-C
5645 MAIN ST
FLUSHING, NY 11355-5045
Phone number: 718-670-2007
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Mailing Address
Mr. MICHAEL B BAUTISTA PA-C
235 WALTON ST
WEST HEMPSTEAD, NY 11552-3027
Phone number: 516-481-0242
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