Provider Demographics
NPI:1790510287
Name:BATTISTI, STEFANIE MARIE
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:MARIE
Last Name:BATTISTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10125 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-1844
Mailing Address - Country:US
Mailing Address - Phone:724-513-6509
Mailing Address - Fax:
Practice Address - Street 1:1885 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2551
Practice Address - Country:US
Practice Address - Phone:724-513-6509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT020328261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy