Provider Demographics
NPI:1861828386
Name:BATTAGLIA, DAWN
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BATTAGLIA
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 1:5225 NESCONSET HWY STE 30
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-2060
Mailing Address - Country:US
Mailing Address - Phone:631-473-4284
Mailing Address - Fax:631-476-0972
Practice Address - Street 1:5225 NESCONSET HWY STE 30
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-2060
Practice Address - Country:US
Practice Address - Phone:631-473-4284
Practice Address - Fax:631-476-0972
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist