Provider Demographics
NPI:1598043515
Name:BATTELLI, DEBORAH ELAINE (RN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELAINE
Last Name:BATTELLI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 COVENTRY AVE
Mailing Address - Street 2:
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-5002
Mailing Address - Country:US
Mailing Address - Phone:631-772-4977
Mailing Address - Fax:
Practice Address - Street 1:34 COVENTRY AVE
Practice Address - Street 2:
Practice Address - City:MASTIC
Practice Address - State:NY
Practice Address - Zip Code:11950-5002
Practice Address - Country:US
Practice Address - Phone:631-772-4977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY641700-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY641700-1Medicaid