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EMMANUEL ESTAVILLO BAUTISTA MD
NPI 1902965106
Family Medicine in Bridgeport, CT

Active since December 06, 2006
SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSKI, 1635 CENTRAL AVENUE ROOM 213, BRIDGEPORT, CT 06610(203) 551-7660(203) 551-7481 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Emmanuel Estavillo Bautista Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EMMANUEL ESTAVILLO BAUTISTA MD (NPI 1902965106) is an individual family medicine provider in Bridgeport, Connecticut, licensed in Connecticut (025021) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1902965106
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameEMMANUEL ESTAVILLO BAUTISTACredential: MD
Location AddressSOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSKI, 1635 CENTRAL AVENUE ROOM 213Bridgeport, CT 06610
Mailing AddressSouthwest Ct Mental Health System Attn Sandra Grazynsk, 1635 Central Avenue Room 213Bridgeport, CT 06610 · (203) 551-7660 · Fax (203) 551-7481
Phone(203) 551-7660
Fax(203) 551-7481
Sole ProprietorNo
Enumeration DateDecember 6, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1902965106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CT · 025021
Definition
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.
SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSKI, Bridgeport, CT 06610
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Other Identifiers 1

Medicare UPINF18164

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID ARTHUR CARLSON MD
Psychiatry & Neurology (Psychiatry)
SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSKI, 1635 CENTRAL AVENUE
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 551-7660
MS. LYNN B RAKOS APRN
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)
SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSKI, 1635 CENTRAL AVENUE
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 551-7660
LUMINA MARY NAZARETH MD
Internal Medicine
SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSKI, 1635 CENTRAL AVENUE ROOM 213
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 551-7660
MS. MARIE ELENA DEJOSEPH LCSW
Social Worker (Clinical)
SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSKI, 1635 CENTRAL AVENUE ROOM 213
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 551-7660

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Emmanuel Bautista's NPI number?

The NPI number for Emmanuel Bautista is 1902965106. It was assigned to this individual provider in the NPPES registry on December 6, 2006.

Where is Emmanuel Bautista located?

Emmanuel Bautista practices at Southwest Ct Mental Health System Attn Sandra Grazynski 1635 Central Avenue Room 213, Bridgeport, CT 06610. The listed phone number is (203) 551-7660.

What is Emmanuel Bautista's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Emmanuel Bautista was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.