Healthcare Provider Details

I. General information

NPI: 1134392145
Provider Name (Legal Business Name): RENATO PIETRO BATTISTI CHIROPRACTOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23059 ROCKAWAY BLVD 225
JAMAICA NY
11413
US

IV. Provider business mailing address

6 MARLBORO RD
WESTBURY NY
11590-1215
US

V. Phone/Fax

Practice location:
  • Phone: 718-244-1644
  • Fax: 718-244-1622
Mailing address:
  • Phone: 516-841-5732
  • Fax: 516-414-4260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License NumberX0098211
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberX0098211
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: