Provider Demographics
NPI:1033615851
Name:VENNERO, DANIEL PAUL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:VENNERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 LEMOINE AVE
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-1012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:KENMORE MERCY HOSPITAL
Practice Address - Street 2:2950 ELMWOOD AVENUE
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14217
Practice Address - Country:US
Practice Address - Phone:716-447-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant