Provider Demographics
NPI:1144092883
Name:BATTAGLINI, MARY E
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:BATTAGLINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-6855
Mailing Address - Country:US
Mailing Address - Phone:570-502-2312
Mailing Address - Fax:
Practice Address - Street 1:1831 WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:PA
Practice Address - Zip Code:18801-6855
Practice Address - Country:US
Practice Address - Phone:570-502-2312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY341874-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse