Healthcare Provider Details

I. General information

NPI: 1023945052
Provider Name (Legal Business Name): BATTISTA PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WORCESTER ST STE 201
WELLESLEY MA
02482-3708
US

IV. Provider business mailing address

165 M ST APT 3
SOUTH BOSTON MA
02127-6627
US

V. Phone/Fax

Practice location:
  • Phone: 716-418-2122
  • Fax:
Mailing address:
  • Phone: 716-418-2122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JILLIAN ELIZABETH BATTISTA
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT,DPT,MS
Phone: 716-418-2122