1003691270 NPI number — CHRISTINA VENEZIANO DADEY LMSW

Table of content: CHRISTINA VENEZIANO DADEY LMSW (NPI 1003691270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003691270 NPI number — CHRISTINA VENEZIANO DADEY LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DADEY
Provider First Name:
CHRISTINA
Provider Middle Name:
VENEZIANO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VENEZIANO
Provider Other First Name:
CHRISTINA
Provider Other Middle Name:
MARIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003691270
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NIAGARA FALLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14301-1156
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-282-1228
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
238 DEUMANT TER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TONAWANDA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14223-2307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-282-1228
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  063499 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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