Provider Demographics
NPI:1639122575
Name:BATLLE, JOSE EUGENIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:EUGENIO
Last Name:BATLLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1487 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4002
Mailing Address - Country:US
Mailing Address - Phone:646-206-1668
Mailing Address - Fax:646-607-7778
Practice Address - Street 1:1487 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4002
Practice Address - Country:US
Practice Address - Phone:646-206-1668
Practice Address - Fax:646-607-7778
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212090207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY212090OtherLICENSE
NY212090OtherLICENSE
NY289AV1Medicare ID - Type Unspecified