Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 04562 | MD |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | R192725 | MD |
NPI | 1215486972 |
---|---|
Provider Name | Betty J. Battaglia |
First Address | Elkton, MD 21921-6764 |
Second Address | Elkton, MD 21921-6764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2016 |
Last Update Date | 11/10/2016 |