Provider Demographics
NPI:1841326626
Name:ELIO VENTRESCA, MD, INC
Entity type:Organization
Organization Name:ELIO VENTRESCA, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:VENTRESCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-459-2906
Mailing Address - Street 1:3650 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3464
Mailing Address - Country:US
Mailing Address - Phone:614-459-2906
Mailing Address - Fax:614-459-2932
Practice Address - Street 1:3650 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 302
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3464
Practice Address - Country:US
Practice Address - Phone:614-459-2906
Practice Address - Fax:614-459-2932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHEL0691915Medicare PIN