Provider Demographics
NPI:1578347936
Name:BATISTA, LOURDES MELISSA
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:MELISSA
Last Name:BATISTA
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 1:421 E 168TH ST APT 9D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-3725
Mailing Address - Country:US
Mailing Address - Phone:347-654-0396
Mailing Address - Fax:
Practice Address - Street 1:421 E 168TH ST APT 9D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-3725
Practice Address - Country:US
Practice Address - Phone:347-654-0396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCF261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech