Individual
ABIGAIL BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-4348
Mailing address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-4348
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
P24-00104
NJ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
04/03/2026
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