Basic Information
Provider Information
NPI: 1538151899
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BATTISTELLA
FirstName: GENE
MiddleName: MICHAEL
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 BOWER HILL ROAD
Address2: ATTN ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
City: PITTSBURGH
State: PA
PostalCode: 152431873
CountryCode: US
TelephoneNumber: 4129422584
FaxNumber:  
Practice Location
Address1: 27 HECKEL RD STE 212
Address2:  
City: MC KEES ROCKS
State: PA
PostalCode: 151361695
CountryCode: US
TelephoneNumber: 4127774319
FaxNumber: 4127774390
Other Information
ProviderEnumerationDate: 08/22/2005
LastUpdateDate: 05/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XOS 008311LPAY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
56243701 AETNAOTHER
P00096601 GATEWAY HEALTH PLANOTHER
11022460201 RAILROAD MEDICAREOTHER
00000009914701 UNISON HEALTH PLANOTHER
001578560000205PA MEDICAID
25117501 UPMC HEALTH PLANOTHER
G4312701 HEALTH AMERICAOTHER
096762300001PAINDEPENDENCE BLUE SHIELDOTHER


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