Individual
ANDREA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103-2496
(973) 972-3466
Mailing address
74 MAPLE ST UNIT 711, JERSEY CITY, NJ 07304-4266
(908) 487-8122
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
011003
NY
224Z00000X
Occupational Therapy Assistant
Primary
46TA09143200
NJ
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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