Provider Demographics
NPI:1508429424
Name:BATTAGLIA, GULDA
Entity Type:Individual
Prefix:
First Name:GULDA
Middle Name:
Last Name:BATTAGLIA
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 1:72 HERMAN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2962
Mailing Address - Country:US
Mailing Address - Phone:201-655-1410
Mailing Address - Fax:
Practice Address - Street 1:72 HERMAN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2962
Practice Address - Country:US
Practice Address - Phone:201-655-1410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
103K00000XOther103K00000X