Provider Demographics
NPI:1932715430
Name:VENTURA, CHRISTIAN ANGELO (RP, NRAEMT, EMT-INST)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN ANGELO
Middle Name:
Last Name:VENTURA
Suffix:
Gender:M
Credentials:RP, NRAEMT, EMT-INST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 VT 110
Mailing Address - Street 2:
Mailing Address - City:TUNBRIDGE
Mailing Address - State:VT
Mailing Address - Zip Code:05077-9578
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:324 VT 110
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:VT
Practice Address - Zip Code:05038
Practice Address - Country:US
Practice Address - Phone:732-372-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-20
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097.0134992102L00000X, 2084B0040X
097.0134992102L00000X
VT105065146M00000X, 146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry