Provider Demographics
NPI:1821491861
Name:VENERE, KENNETH (DPT)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:VENERE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02364-1282
Mailing Address - Country:US
Mailing Address - Phone:781-585-8558
Mailing Address - Fax:781-585-1279
Practice Address - Street 1:535 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-5261
Practice Address - Country:US
Practice Address - Phone:781-961-3370
Practice Address - Fax:781-767-7531
Is Sole Proprietor?:No
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist