Provider Demographics
NPI:1700068681
Name:NC BATTAFARANO, MD PC
Entity Type:Organization
Organization Name:NC BATTAFARANO, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BATTAFARANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-688-5477
Mailing Address - Street 1:1110 W VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1440
Mailing Address - Country:US
Mailing Address - Phone:610-688-5477
Mailing Address - Fax:610-688-7274
Practice Address - Street 1:1110 W VALLEY RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1440
Practice Address - Country:US
Practice Address - Phone:610-688-5477
Practice Address - Fax:610-688-7274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022861L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA629930Medicare PIN