Provider Demographics
NPI:1437334448
Name:BATTISTI, CAROL
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:BATTISTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 PORT WATSON ST
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-3125
Mailing Address - Country:US
Mailing Address - Phone:607-756-7591
Mailing Address - Fax:607-758-7445
Practice Address - Street 1:170 PORT WATSON ST
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-3125
Practice Address - Country:US
Practice Address - Phone:607-756-7591
Practice Address - Fax:607-758-7445
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist