MEDICARE: DR. DEBBIE P. BAUTISTA-HUSSEY D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	N006117	NY

General Provider Information

NPI Number	:	1174502751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBBIE P. BAUTISTA-HUSSEY D.P.M.

Provider Business Mailing Address
First Line	:	185 HOBART ST
Second Line	:
City	:	PEARL RIVER
State	:	NY
Zip	:	10965-1838
Country	:	US
Telephone Number	:	646-251-3372
Fax Number	:

Provider Business Practice Location Address
First Line	:	391 E 149TH ST
Second Line	:	SUITE 216
City	:	BRONX
State	:	NY
Zip	:	10455-3907
Country	:	US
Telephone Number	:	718-292-7081
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	08/03/2011

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