Provider Demographics
NPI:1679634760
Name:BAUTISTA, JUDITA BALTASAR (MD)
Entity Type:Individual
Prefix:
First Name:JUDITA
Middle Name:BALTASAR
Last Name:BAUTISTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TUDOR CITY PL
Mailing Address - Street 2:#6K-NORTH
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6800
Mailing Address - Country:US
Mailing Address - Phone:212-263-6594
Mailing Address - Fax:
Practice Address - Street 1:BELLEVUE HOSPITAL CENTER, WOMEN'S HEALTH SERVICES
Practice Address - Street 2:462 FIRST AVE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-562-5755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192343207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology