Basic Information
| Provider Information | |||||||||
| NPI: | 1184155111 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BATAILLE | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 123 BRUNO RD | ||||||||
| Address2: | |||||||||
| City: | CANASTOTA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130321103 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 526 OLD LIVERPOOL RD | ||||||||
| Address2: | |||||||||
| City: | LIVERPOOL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130886238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154533911 | ||||||||
| FaxNumber: | 3154530197 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2017 | ||||||||
| LastUpdateDate: | 09/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 275835 | NY | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.