Provider Demographics
NPI:1609113976
Name:WASHINGTONVILLE OPTOMETRY, PC
Entity Type:Organization
Organization Name:WASHINGTONVILLE OPTOMETRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTIATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-496-9999
Mailing Address - Street 1:PO BOX 418
Mailing Address - Street 2:
Mailing Address - City:BLOOMING GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:10914-0418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2877 ROUTE 94
Practice Address - Street 2:FIELDSTONE SQUARE SUITE 2
Practice Address - City:BLOOMING GROVE
Practice Address - State:NY
Practice Address - Zip Code:10914-0418
Practice Address - Country:US
Practice Address - Phone:845-496-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV5971152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty