Provider Demographics
NPI:1366533945
Name:BATAILLE-GOSSARD, REGINE LYDIE (OD)
Entity type:Individual
Prefix:DR
First Name:REGINE
Middle Name:LYDIE
Last Name:BATAILLE-GOSSARD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:REGINE
Other - Middle Name:LYDIE
Other - Last Name:BATAILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2920 DARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010
Mailing Address - Country:US
Mailing Address - Phone:724-847-3350
Mailing Address - Fax:
Practice Address - Street 1:WALMART VISION CENTER
Practice Address - Street 2:WALMART PLAZA ROUTE 18
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061
Practice Address - Country:US
Practice Address - Phone:724-773-2930
Practice Address - Fax:724-773-2932
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET009042152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist