Provider Demographics
NPI:1558387597
Name:VENTURA, DOMINIC GENO (DO)
Entity Type:Individual
Prefix:DR
First Name:DOMINIC
Middle Name:GENO
Last Name:VENTURA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 KNOWLSON AVE
Mailing Address - Street 2:CHIPPEWA TOWNSHIP
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1634
Mailing Address - Country:US
Mailing Address - Phone:724-891-2100
Mailing Address - Fax:724-891-2734
Practice Address - Street 1:100 KNOWLSON AVENUE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1634
Practice Address - Country:US
Practice Address - Phone:724-891-2100
Practice Address - Fax:724-891-2734
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013086207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine