Individual
JESSICA MAY BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 LONG WHARF DR STE 302, NEW HAVEN, CT 06511-5593
(203) 777-7500
Mailing address
1050 STATE ST APT 150, NEW HAVEN, CT 06511-2763
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/27/2022
Last updated
07/29/2022
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