Provider Demographics
NPI:1912205956
Name:BATION, LUDIVINA SALON
Entity Type:Individual
Prefix:MRS
First Name:LUDIVINA
Middle Name:SALON
Last Name:BATION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUDIVINA
Other - Middle Name:SALON
Other - Last Name:DAOMILAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1661 SEDDON ST
Mailing Address - Street 2:1ST FLR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:551-358-3610
Mailing Address - Fax:
Practice Address - Street 1:1661 SEDDON ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:551-358-3610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030632225100000X
NY030632-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist