Provider Demographics
NPI:1356308563
Name:VENEZIANO, MEGAN RACHAEL (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:RACHAEL
Last Name:VENEZIANO
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:RACHAEL
Other - Last Name:RICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:6255 SHERIDAN DRIVE,
Mailing Address - Street 2:SUITE 304 BUFFALO MEDICAL GROUP
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-857-8666
Mailing Address - Fax:716-857-8944
Practice Address - Street 1:ELM AND CARLTON STREETS
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008319-1363AM0700X
NY008319363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP54989Medicare UPIN
NYJ400005328Medicare PIN