Provider Demographics
NPI:1982880399
Name:BATTAGLIA, STEPHEN VINCENT
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:VINCENT
Last Name:BATTAGLIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 STONEBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-5515
Mailing Address - Country:US
Mailing Address - Phone:315-733-5634
Mailing Address - Fax:
Practice Address - Street 1:2308 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1746
Practice Address - Country:US
Practice Address - Phone:315-624-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist