Individual
EMMANUEL ESTAVILLO BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSKI, 1635 CENTRAL AVENUE ROOM 213, BRIDGEPORT, CT 06610
(203) 551-7660
(203) 551-7481
Mailing address
SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSK, 1635 CENTRAL AVENUE ROOM 213, BRIDGEPORT, CT 06610
(203) 551-7660
(203) 551-7481
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
025021
CT
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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