Provider Demographics
NPI:1245427095
Name:VENNIRO, ERIKA KRISTIN (RPAC)
Entity Type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:KRISTIN
Last Name:VENNIRO
Suffix:
Gender:F
Credentials:RPAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 675
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642
Mailing Address - Country:US
Mailing Address - Phone:585-275-7753
Mailing Address - Fax:585-461-0662
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX SURG
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-8410
Practice Address - Country:US
Practice Address - Phone:585-275-2876
Practice Address - Fax:585-276-1992
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2023-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY12021363AS0400X
NY012021363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02983342Medicaid
NYPA2464Medicare PIN