Provider Demographics
NPI:1871996504
Name:BATTISTE, PAUL ANTHONY JR (OPTICIAN)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ANTHONY
Last Name:BATTISTE
Suffix:JR
Gender:M
Credentials:OPTICIAN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:67 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-1226
Mailing Address - Country:US
Mailing Address - Phone:212-627-3937
Mailing Address - Fax:212-627-0174
Practice Address - Street 1:67 8TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-1226
Practice Address - Country:US
Practice Address - Phone:212-627-3937
Practice Address - Fax:212-627-0174
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY55007837156FX1100X, 156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician