| Doctor Name: | MS. PEGGY ELIZABETH BAUTISTA |
| NPI Number: | 1023106556 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, OTR/L |
| License Number: | 46TR00376300 |
| Business Practice Address: | 33-00 Broadway Fair Lawn, NJ - 074104617 |
| Business Phone Number: | 2017038820 |
| Business Fax Number: | |
| Mailing Address: | 52 North Ave, BLOOMFIELD |
| State: | NJ |
| Postal Code: | 070035517 |
| Phone Number: | 9732022525 |
| Fax Number: | |
| NPI Enumeration Date: | 10/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225XH1200X |
| License Number: | 46TR00376300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Occupational Therapist |
| Taxonomy Specialization: | Hand |
| Taxonomy Definition: | |