Provider Demographics
NPI:1780854794
Name:VENESKI, JASON JAMES (PT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:JAMES
Last Name:VENESKI
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 1:16 LYNNVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:PA
Mailing Address - Zip Code:15057-2578
Mailing Address - Country:US
Mailing Address - Phone:412-257-8221
Mailing Address - Fax:
Practice Address - Street 1:159 WATERDAM RD
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2576
Practice Address - Country:US
Practice Address - Phone:724-942-1511
Practice Address - Fax:724-942-1513
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-019127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist