EMMANUEL ESTAVILLO BAUTISTA (NPI# 1902965106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902965106 |
| Entity Type | Individual |
| Full Name | EMMANUEL ESTAVILLO BAUTISTA |
| Credential | MD |
| Practice Address |
Southwest Ct Mental Health System Attn Sandra Grazynski 1635 Central Avenue Room 213 Bridgeport CT 06610 |
| Mailing Address |
Southwest Ct Mental Health System Attn Sandra Grazynsk 1635 Central Avenue Room 213 Bridgeport CT 06610 |
| Practice Telephone | 2035517660 |
| Practice Fax Number | 2035517481 |
| Mailing Telephone | 2035517660 |
| Mailing Fax Number | 2035517481 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 025021 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSKI 1635 CENTRAL AVENUE ROOM 213 |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205917655 | Lynn B Rakos | Clinical Nurse Specialist | Southwest Ct Mental Health System Attn Sandra Grazynski, 1635 Central Avenue, Bridgeport, CT 06610 | 2006-10-18 |
| 1912065269 | Marie Elena Dejoseph | Social Worker | Southwest Ct Mental Health System Attn Sandra Grazynski, 1635 Central Avenue Room 213, Bridgeport, CT 06610 | 2006-12-05 |
| 1396803649 | Lumina Mary Nazareth | Internal Medicine | Southwest Ct Mental Health System Attn Sandra Grazynski, 1635 Central Avenue Room 213, Bridgeport, CT 06610 | 2006-12-05 |
| 1093896441 | David Arthur Carlson | Psychiatry & Neurology | Southwest Ct Mental Health System Attn Sandra Grazynski, 1635 Central Avenue, Bridgeport, CT 06610 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215553698 | Juan G Farfan | Nurse Anesthetist, Certified Registered | 267 Grant Sreet, Bridgeport, CT 06610 | 2020-06-22 |
| 1104446145 | Deepak Rajkumar Vangipuram | Student in an Organized Health Care Education/Training Program | Department of Medicine, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-20 |
| 1275152886 | Soniya Abraham | Student in an Organized Health Care Education/Training Program | Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-14 |
| 1538621834 | Yu Mi Kang | Student in an Organized Health Care Education/Training Program | 267 Grant Street, Yale New Haven Health/bridgeport Hosp, Bridgeport, CT 06610 | 2019-04-04 |
| 1073075024 | Ashwin Pramod Deshmukh | Student in an Organized Health Care Education/Training Program | Yale New Haven Health / Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2019-04-01 |
| 1790246866 | Prachi Mangesh Pednekar | Student in an Organized Health Care Education/Training Program | Yale New Haven Health/bridgeport Hospital, 261 Grant Street Department of Internal Medicine, Bridgeport, CT 06610 | 2019-03-29 |
| 1194247916 | Jessica M. Maddern | Social Worker | 1558 Barnum Avenue, Building C, Bridgeport, CT 06610 | 2017-07-13 |
| 1922532746 | Megha Kureti | Student in an Organized Health Care Education/Training Program | 267 Grant St Fl 3, Bridgeport, CT 06610 | 2017-04-18 |
| 1831623099 | Cynthia Joseph Walters | Nurse Anesthetist, Certified Registered | Bridgeport Hospital-anesthesia Department, 267 Grant Street, Bridgeport, CT 06610 | 2017-04-14 |
| 1285186148 | Helen Leahy | Nurse Practitioner | 439 Mill Hill Ave., Bridgeport, CT 06610 | 2016-10-26 |
| Find all providers in zip 06610 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1780158287 | Rejuvenation Medspa | Family Medicine | 1400 Johnson Ave Ste 4a, Bridgeport, WV 26330-1063 | 2019-01-17 |
| 1497244321 | Sanitas of Connecticut LLC | Family Medicine | 4551 Main St, Bridgeport, CT 06606-1818 | 2018-05-07 |
| 1023471299 | Qmg4, LLC | Family Medicine | 4200 Main Street, Bridgeport, CT 06606 | 2016-04-04 |
| 1013395755 | Clinisanitas, PC | Family Medicine | 4543 Main St, Bridgeport, CT 06606-1818 | 2015-05-14 |
| 1982941431 | Razia Sultana Hashmi | Family Medicine | 115 Highland Ave, Bridgeport, CT 06604-3549 | 2013-01-03 |
| 1508025594 | Awais Malik | Family Medicine | 754 Clinton Ave, Bridgeport, CT 06604-2301 | 2008-06-04 |
| 1508062423 | Bridgeport Family Practice Obgyn Clinic | Family Medicine | 615 Kendall Ave, Bridgeport, AL 35740 | 2007-06-26 |
| 1760505887 | Vinai Montricul | Family Medicine | 47910 Al Highway 277, Bridgeport, AL 35740-7206 | 2007-04-06 |
| 1942341060 | Zijad Sabovic | Family Medicine | 3000 Park Ave, Bridgeport, CT 06604-1105 | 2007-02-09 |
| 1538207295 | Bridgeport Family Health LLC | Family Medicine | 1381 Reservoir Avenue, Bridgeport, CT 06606-2502 | 2007-02-02 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06610 |
Please comment or provide details below to improve the information on EMMANUEL ESTAVILLO BAUTISTA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.