Provider Demographics
NPI:1386650570
Name:BATTISTA-HODGE, MICHELE MARIE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:MARIE
Last Name:BATTISTA-HODGE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-2160
Mailing Address - Fax:716-692-4342
Practice Address - Street 1:230 S CASCADE DR
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-9275
Practice Address - Country:US
Practice Address - Phone:716-592-3600
Practice Address - Fax:716-592-3636
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY420181363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01281763Medicaid