Basic Information
| Provider Information | |||||||||
| NPI: | 1477524791 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BATT | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 FOUNTAIN PLZ | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142022211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4166918838 | ||||||||
| FaxNumber: | 7165641134 | ||||||||
| Practice Location | |||||||||
| Address1: | 921 WAYNE ST | ||||||||
| Address2: | |||||||||
| City: | OLEAN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147602255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163798608 | ||||||||
| FaxNumber: | 7165641134 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2006 | ||||||||
| LastUpdateDate: | 09/15/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 173000000X | ME0076924 | FL | N | Other Service Providers | Legal Medicine | 207Q00000X | 217829 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | 217829 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 5009 | 01 | FL | UHC OF NY | OTHER | ME0076924 | 01 | FL | HUMANA | OTHER | ME0076924 | 01 | FL | VHN | OTHER | 258359300 | 05 | FL | MEDICAID | 5009 | 01 | FL | BCBS | OTHER | 80178849 | 01 | FL | RAILROAD | OTHER |