Provider Demographics
NPI:1467756270
Name:BATISTA FARES, BETULIA (MD)
Entity Type:Individual
Prefix:DR
First Name:BETULIA
Middle Name:
Last Name:BATISTA FARES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E 72ND ST
Mailing Address - Street 2:APT 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4233
Mailing Address - Country:US
Mailing Address - Phone:212-570-1289
Mailing Address - Fax:
Practice Address - Street 1:130 E 72ND ST
Practice Address - Street 2:APT 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4233
Practice Address - Country:US
Practice Address - Phone:212-570-1289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-08
Last Update Date:2011-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143784207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology