Healthcare Provider Details

I. General information

NPI: 1669321170
Provider Name (Legal Business Name): REBECCA LYNN BATTISTA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3332 WALDEN AVE STE 110
DEPEW NY
14043-2400
US

IV. Provider business mailing address

189 BEALE AVE
CHEEKTOWAGA NY
14225-2107
US

V. Phone/Fax

Practice location:
  • Phone: 716-668-7051
  • Fax:
Mailing address:
  • Phone: 716-715-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number358753
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: