Provider Demographics
NPI:1134108558
Name:BATTAGLIA, TODD CHRISTOPHER (MD MS)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:CHRISTOPHER
Last Name:BATTAGLIA
Suffix:
Gender:M
Credentials:MD MS
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Other - Last Name:
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Mailing Address - Street 1:5824 WIDEWATERS PARKWAY
Mailing Address - Street 2:SYRACUSE ORTHOPEDIC SPECIALISTS
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057
Mailing Address - Country:US
Mailing Address - Phone:315-251-3105
Mailing Address - Fax:315-552-6018
Practice Address - Street 1:5179 WIDEWATERS PARKWAY
Practice Address - Street 2:SYRACUSE ORTHOPEDIC SPECIALISTS
Practice Address - City:DEWITT
Practice Address - State:NY
Practice Address - Zip Code:13214
Practice Address - Country:US
Practice Address - Phone:315-251-3500
Practice Address - Fax:315-449-0238
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2018-04-05
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Provider Licenses
StateLicense IDTaxonomies
MA223417207X00000X
NY249055207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2106353Medicaid
NY02986143Medicaid