Provider Demographics
NPI:1972609626
Name:BATTAGLIA, ANTHONY SCOTT (OD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:SCOTT
Last Name:BATTAGLIA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:10949 ALAMEDA PATH
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55077
Mailing Address - Country:US
Mailing Address - Phone:651-455-5797
Mailing Address - Fax:651-455-5797
Practice Address - Street 1:3001 WHITE BEAR AVE N
Practice Address - Street 2:2011
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1215
Practice Address - Country:US
Practice Address - Phone:651-704-0490
Practice Address - Fax:651-704-0589
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNMN2392152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU46964Medicare UPIN