Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | 55007837 | NY |
N | 156FX1800X | Optician | 55007837 | NY |
NPI | 1871996504 |
---|---|
Provider Name | Mr. Paul Anthony Battiste JR. |
First Address | New York, NY 10014-1226 |
Second Address | New York, NY 10014-1226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2014 |
Last Update Date | 08/10/2014 |