Bautista, Rosa E

Bautista, Rosa E is an sole proprietor health care provider with primary practice located at 19 Greenridge Ave , White Plains NY 10605-1201. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Bautista, Rosa E can be contacted via phone (914) 949-7680.

Contact Information

Primary practice address
19 Greenridge Ave White Plains NY 10605-1201
Phone: (914) 949-7680
Fax: (914) 997-4972
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 052760 New York
Behavioral Health & Social Service Providers / Psychologist 103T00000X

Profile Details

NPI number 1245391721
LBN Legal business name Bautista, Rosa E
Credentials MSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2006
Last updated Apr 6th, 2010 - about 15 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 1245391721 NPPES
New York Other 00355940 AGENCY MEDICAID PROVIDER ID
New York Other 1285628552 AGENCY MEDICAID PROVIDER ID
New York Other WVE061 AGENCY MEDICAID PROVIDER ID

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