Individual
ROBERTSON BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
39 LANRAM RD, TAPPAN, NY 10983-1735
(845) 668-0255
Mailing address
39 LANRAM RD, TAPPAN, NY 10983-1735
(845) 668-0255
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010049-01
NY
Other
Enumeration date
12/31/2025
Last updated
12/31/2025
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