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General NPI Number Information
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NPI Number | 1861306706
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Entity Type | Individual
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Provider Name | KATELYN ANN IGNACIO BAUTISTA PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 215 E 95TH ST STE I
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City | NEW YORK
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State | NY
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Zip | 10128-4077
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Country | US
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Telephone | 718-732-4049
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Fax |
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Provider Business Mailing Address
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Address Line | 60 E 34TH ST APT 4F
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City | NEW YORK
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State | NY
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Zip | 10016-4331
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Country | US
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Telephone | 818-653-6353
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | NULL
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