Provider Demographics
NPI:1669699047
Name:BATTIPAGLIA, JAMES (LICENSED OPTICIAN)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:BATTIPAGLIA
Suffix:
Gender:M
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MERIDEN AVE
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-3238
Mailing Address - Country:US
Mailing Address - Phone:860-621-8215
Mailing Address - Fax:860-621-8215
Practice Address - Street 1:55 MERIDEN AVE
Practice Address - Street 2:SUITE 2F
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-3238
Practice Address - Country:US
Practice Address - Phone:860-621-8215
Practice Address - Fax:860-621-8215
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000835156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT100000835CT01OtherOPTICAL
CT0573560001Medicare ID - Type UnspecifiedOPTICAL