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Individual

LUCIEN S BAUTISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
200 STRYKERS RD, PHILLIPSBURG, NJ 08865-9488
(908) 859-6568
(908) 859-6697
Mailing address
PO BOX 27957, SALT LAKE CITY, UT 84127-0957
(908) 835-1910
(908) 835-1924

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MB68661
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080176344
RAILROAD MEDICARE
NJ
Enumeration date
03/22/2006
Last updated
03/19/2020
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