1780631077 NPI number — RICHARD BATTAGLINI PT

Table of content: RICHARD BATTAGLINI PT (NPI 1780631077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780631077 NPI number — RICHARD BATTAGLINI PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BATTAGLINI
Provider First Name:
RICHARD
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780631077
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1265 WAYNE AVE STE 308
Provider Second Line Business Mailing Address:
119 PROFESSINAL BUILDING
Provider Business Mailing Address City Name:
INDIANA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15701-3501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-801-8095
Provider Business Mailing Address Fax Number:
724-801-8147

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 STATE RD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
MEDIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19063-1452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-892-7344
Provider Business Practice Location Address Fax Number:
610-565-0500
Provider Enumeration Date:
05/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  J1-0001501 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 25733 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT013499L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2844946000 . This is a "IBC" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: AC44-0023 . This is a "CAREFIRST" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 0962113000 . This is a "IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3211151 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1300966 . This is a "HIGHMARK PABS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1780631077 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50108718 . This is a "CAPITAL BC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1780631077 . This is a "BRAVO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001874791 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 058152VLZ . This is a "MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00713330 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: P00713327 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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