Provider Demographics
NPI:1760671226
Name:EUGENE A BATELLI DPM PC
Entity type:Organization
Organization Name:EUGENE A BATELLI DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BATELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-837-8173
Mailing Address - Street 1:195 US HIGHWAY 46
Mailing Address - Street 2:SUITE 12
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1824
Mailing Address - Country:US
Mailing Address - Phone:973-837-8173
Mailing Address - Fax:973-837-8174
Practice Address - Street 1:195 US HIGHWAY 46
Practice Address - Street 2:SUITE 12
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1824
Practice Address - Country:US
Practice Address - Phone:973-837-8173
Practice Address - Fax:973-837-8174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2920213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8408Medicare PIN
NJ032800Medicare PIN