Provider Demographics
NPI:1447439963
Name:BATTAGLIA, J. ANDREW (RPH)
Entity type:Individual
Prefix:MR
First Name:J. ANDREW
Middle Name:
Last Name:BATTAGLIA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ARCADE
Mailing Address - State:NY
Mailing Address - Zip Code:14009-1508
Mailing Address - Country:US
Mailing Address - Phone:585-492-3090
Mailing Address - Fax:
Practice Address - Street 1:658 MAIN ST
Practice Address - Street 2:
Practice Address - City:ARCADE
Practice Address - State:NY
Practice Address - Zip Code:14009-1037
Practice Address - Country:US
Practice Address - Phone:585-496-5379
Practice Address - Fax:585-496-5418
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030693183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist