Provider Demographics
NPI:1336123652
Name:BATELLI, EUGENE A (DPM)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:A
Last Name:BATELLI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 US HIGHWAY 46
Mailing Address - Street 2:SUITE 12
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1824
Mailing Address - Country:US
Mailing Address - Phone:973-837-8173
Mailing Address - Fax:973-837-8174
Practice Address - Street 1:195 US HIGHWAY 46
Practice Address - Street 2:SUITE 12
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1824
Practice Address - Country:US
Practice Address - Phone:973-837-8173
Practice Address - Fax:973-837-8174
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00255600213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
477594Medicare UPIN
NJU77594Medicare UPIN
NJ032800Medicare ID - Type UnspecifiedNJ MEDICARE
NJ4101250001Medicare NSC
4101250001Medicare PIN