Healthcare Provider Details

I. General information

NPI: 1467239079
Provider Name (Legal Business Name): DR. KYRA BATTAGLIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 LINCOLN ST STE 2400
HINGHAM MA
02043-1579
US

IV. Provider business mailing address

350 LINCOLN ST STE 2400
HINGHAM MA
02043-1579
US

V. Phone/Fax

Practice location:
  • Phone: 508-812-7994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KYRA BATTAGLIA
Title or Position: PSYCHOLOGIST
Credential:
Phone: 508-812-7994