Individual
FREDDIE BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 W JERSEY ST APT 1B, ELIZABETH, NJ 07202-1314
(908) 230-8785
Mailing address
220 W JERSEY ST APT 1B, ELIZABETH, NJ 07202-1314
(908) 230-8785
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ15087100
NJ
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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