Provider Demographics
NPI:1902227515
Name:BATTIATO, FERDINAND (LSW)
Entity Type:Individual
Prefix:MR
First Name:FERDINAND
Middle Name:
Last Name:BATTIATO
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:MR
Other - First Name:FRED
Other - Middle Name:
Other - Last Name:BATTIATO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:PO BOX 2036
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-8036
Mailing Address - Country:US
Mailing Address - Phone:732-244-3002
Mailing Address - Fax:
Practice Address - Street 1:1000 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6855
Practice Address - Country:US
Practice Address - Phone:732-244-3002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05472100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker