Provider Demographics
NPI:1780701284
Name:BATTAGLIA, JENNIFER ANNE (PA, MS, ATC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:BATTAGLIA
Suffix:
Gender:F
Credentials:PA, MS, ATC
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Other - Middle Name:
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Mailing Address - Street 1:621 10TH ST
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1813
Mailing Address - Country:US
Mailing Address - Phone:716-278-4402
Mailing Address - Fax:716-278-4364
Practice Address - Street 1:621 TENTH STREET
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14302
Practice Address - Country:US
Practice Address - Phone:716-278-4402
Practice Address - Fax:716-278-4364
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0011742255A2300X
NY016444-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer