Provider Demographics
NPI:1871818112
Name:BATTAGLIA, JOSEPH M JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:M
Last Name:BATTAGLIA
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5052
Mailing Address - Country:US
Mailing Address - Phone:718-769-7403
Mailing Address - Fax:
Practice Address - Street 1:2712 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5052
Practice Address - Country:US
Practice Address - Phone:718-769-7403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036852183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01013730Medicaid