Provider Demographics
NPI:1598402695
Name:VENEZIA, DORI ANN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:DORI
Middle Name:ANN
Last Name:VENEZIA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 HIGH VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-6133
Mailing Address - Country:US
Mailing Address - Phone:845-661-5572
Mailing Address - Fax:
Practice Address - Street 1:70 HIGH VIEW DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-6133
Practice Address - Country:US
Practice Address - Phone:845-661-5572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY735586163WE0003X
NY733586163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency