MEDICARE: DR. SEAN KENNETH BATTISTI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35.130213	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891115788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN KENNETH BATTISTI M.D.

Provider Business Mailing Address
First Line	:	14401 SNOW RD STE 106
Second Line	:
City	:	BROOKPARK
State	:	OH
Zip	:	44142-2583
Country	:	US
Telephone Number	:	216-898-2229
Fax Number	:	216-898-2217

Provider Business Practice Location Address
First Line	:	14401 SNOW RD STE 106
Second Line	:
City	:	BROOKPARK
State	:	OH
Zip	:	44142-2583
Country	:	US
Telephone Number	:	216-898-2229
Fax Number	:	216-898-2217

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2014
Last Update Date	:	02/21/2019

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Directions to “ DR. SEAN KENNETH BATTISTI M.D.” Practice Location

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