Individual ProviderDalia BautistaSocial WorkerBehavioral Health & Social Service ProvidersPractice Address276 5th Avenue, Suite 704, New York, NY 10001(646) 470-8267PECOS EnrollmentBased on the most recent information from CMS, provider Dalia Bautista is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:04 AM.Profile DetailsProvider ID1144638354Provider TypeIndividualFull NameBautista, DaliaTitleMs.CredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date7/31/2014Last Updated8/3/2021Contact InformationPractice LocationPractice Address276 5th Avenue, Suite 704, New York, NY 10001Phone(646) 470-8267Fax(646) 810-7133Mailing LocationMailing Address276 5th Ave, Ste 704, New York, NY 10001-5699Phone(646) 470-8267Fax(646) 810-7133Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense089018New YorkCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense089572-1New York