Provider Demographics
NPI:1376690149
Name:VENO, ERIC
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:VENO
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 1:15 RYE ST STE 125
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-6839
Mailing Address - Country:US
Mailing Address - Phone:603-310-2200
Mailing Address - Fax:603-610-2202
Practice Address - Street 1:15 RYE ST STE 125
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-6839
Practice Address - Country:US
Practice Address - Phone:603-310-2200
Practice Address - Fax:603-610-2202
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH08Y004169NH01OtherANTHEM PROVIDER NUMBER
NH542065286OtherTAX IDENTIFICATION NUMBER
NH626470OtherHPHC PROVIDER NUMBER
NHRE7009Medicare PIN