Healthcare Provider Details

I. General information

NPI: 1457975518
Provider Name (Legal Business Name): NICHOLAS ROCCO BATTAGLIA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3902 WILSON BLVD
ARLINGTON VA
22203-1953
US

IV. Provider business mailing address

3902 WILSON BLVD STE 200
ARLINGTON VA
22203-1953
US

V. Phone/Fax

Practice location:
  • Phone: 571-560-2648
  • Fax: 571-560-2649
Mailing address:
  • Phone: 571-560-2648
  • Fax: 571-560-2649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102207612
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: