Bautista, Eduardo R

Bautista, Eduardo R is an individual health care provider with primary practice located at 19 Davis Ave Fl 7 , Neptune NJ 07753-4488. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is his primary health care specialty. Bautista, Eduardo R can be contacted via phone (732) 776-4524.

Contact Information

Primary practice address
19 Davis Ave Fl 7 Neptune NJ 07753-4488
Phone: (732) 776-4524
Fax: (732) 776-4639
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MA062854 New Jersey
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 25MA06285400 New Jersey

Profile Details

NPI number 1265405880
LBN Legal business name Bautista, Eduardo R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Nov 11th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265405880 NPPES
New Jersey MEDICAID 7856506

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