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 Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 2:56 PM.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