Provider Demographics
NPI:1689076663
Name:BATISTA, JOSE
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:BATISTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3613 COVENTRY CT
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17406-6608
Mailing Address - Country:US
Mailing Address - Phone:717-679-4734
Mailing Address - Fax:
Practice Address - Street 1:2845 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2909
Practice Address - Country:US
Practice Address - Phone:717-840-6444
Practice Address - Fax:717-757-2555
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002147101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health