Provider Demographics
NPI:1932277191
Name:LOMONGO, VENERANDO C (PT)
Entity Type:Individual
Prefix:MR
First Name:VENERANDO
Middle Name:C
Last Name:LOMONGO
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:346 1ST ST
Mailing Address - Street 2:C/O HOME THERAPY PT LLC
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1906
Mailing Address - Country:US
Mailing Address - Phone:347-708-9701
Mailing Address - Fax:347-708-9701
Practice Address - Street 1:346 1ST ST
Practice Address - Street 2:C/O HOME THERAPY PT LLC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1906
Practice Address - Country:US
Practice Address - Phone:347-708-9701
Practice Address - Fax:347-708-9701
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYD207381225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q07C010Medicare ID - Type Unspecified