Healthcare Provider Details

I. General information

NPI: 1750337218
Provider Name (Legal Business Name): CAROL DAWN BATRA F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 PROSPECT ST
ATTICA NY
14011-1149
US

IV. Provider business mailing address

107 PROSPECT STREET
ATTICA NY
14011-1149
US

V. Phone/Fax

Practice location:
  • Phone: 585-591-6000
  • Fax: 585-591-6962
Mailing address:
  • Phone: 585-591-6000
  • Fax: 585-591-6962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF3323861
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: