Healthcare Provider Details

I. General information

NPI: 1447439963
Provider Name (Legal Business Name): J. ANDREW BATTAGLIA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

658 MAIN ST
ARCADE NY
14009-1037
US

IV. Provider business mailing address

255 PARK ST
ARCADE NY
14009-1508
US

V. Phone/Fax

Practice location:
  • Phone: 585-496-5379
  • Fax: 585-496-5418
Mailing address:
  • Phone: 585-492-3090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number030693
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: