Provider Demographics
NPI:1336167592
Name:VENUTO, ANN (NP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:VENUTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:124 TIMBERLANE DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-1434
Mailing Address - Country:US
Mailing Address - Phone:716-626-9016
Mailing Address - Fax:716-626-4271
Practice Address - Street 1:5330 MAIN ST
Practice Address - Street 2:SUITE 240
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5360
Practice Address - Country:US
Practice Address - Phone:716-626-9016
Practice Address - Fax:716-626-4271
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY400891363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA7426Medicare ID - Type Unspecified