Basic Information
| Provider Information | |||||||||
| NPI: | 1730278391 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BATLIVALA | ||||||||
| FirstName: | SAROSH | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3333 BURNET AVE. | ||||||||
| Address2: | ML 2003 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452293026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136364432 | ||||||||
| FaxNumber: | 5136363952 | ||||||||
| Practice Location | |||||||||
| Address1: | 3333 BURNET AVE. | ||||||||
| Address2: | ML 2003 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452293026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136364432 | ||||||||
| FaxNumber: | 5136363952 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 09/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | 2446 | MS | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 208000000X | TRN9475 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0202X | 51288 | KY | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | 2080P0202X | MD446157 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | 2080P0202X | 22689 | MS | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | 2080P0202X | 35.132713 | OH | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 00432556 | 05 | MS | MEDICAID | P01721900 | 01 | MS | RAILROAD MEDICARE PTAN | OTHER |