Provider Demographics
NPI:1285688085
Name:VENTURINI, GLENN E (PT)
Entity Type:Individual
Prefix:MR
First Name:GLENN
Middle Name:E
Last Name:VENTURINI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 S CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-2710
Mailing Address - Country:US
Mailing Address - Phone:610-543-4605
Mailing Address - Fax:
Practice Address - Street 1:719 S CHESTER RD
Practice Address - Street 2:
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-2710
Practice Address - Country:US
Practice Address - Phone:610-543-4605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-012389-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA022926V8ZMedicare UPIN