Healthcare Provider Details

I. General information

NPI: 1447113279
Provider Name (Legal Business Name): CAROLIN DEL PILAR BAUTISTA LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 TREMONT AVE
EAST ORANGE NJ
07018-1023
US

IV. Provider business mailing address

200 POINT BREEZE DR
HEWITT NJ
07421-1802
US

V. Phone/Fax

Practice location:
  • Phone: 973-676-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07154000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: