National Provider Identifier
Elissa Bautista, PA-C
Elissa Bautista, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Buffalo, NY and a listed phone number of (716) 883-7000.
Profile Overview
- NPI
- 1205705449
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- November 04, 2025
- Last Updated
- November 04, 2025
Practice Location
- 2001 Main St
- Buffalo, NY 14208-1035
Phone: (716) 883-7000
Mailing Address
- 4 Maple Ave
- Lynbrook, NY 11563-2531
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1205705449
- Entity Type
- Individual
- Last Name
- Bautista
- First Name
- Elissa
- Credential
- PA-C
- Mailing Street Address
- 4 Maple Ave
- Mailing City
- Lynbrook
- Mailing State
- NY
- Mailing ZIP Code
- 11563-2531
- Mailing Country
- US
- Mailing Phone
- (516) 946-0632
- Practice Street Address
- 2001 Main St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14208-1035
- Practice Country
- US
- Practice Phone
- (716) 883-7000
- Enumeration Date
- November 04, 2025
- Last Updated
- November 04, 2025
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- November 04, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)