1356645170 NPI number — MS. ANNE DEBORAH VENEZIANO LISW-S, JD

Table of content: MS. ANNE DEBORAH VENEZIANO LISW-S, JD (NPI 1356645170)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356645170 NPI number — MS. ANNE DEBORAH VENEZIANO LISW-S, JD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VENEZIANO
Provider First Name:
ANNE
Provider Middle Name:
DEBORAH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LISW-S, JD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356645170
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2440 SOM CENTER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEPPER PIKE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44124-4214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-926-7091
Provider Business Mailing Address Fax Number:
216-292-0033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8227 BRECKSVILLE RD
Provider Second Line Business Practice Location Address:
STE 104
Provider Business Practice Location Address City Name:
BRECKSVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44141-1370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-926-7091
Provider Business Practice Location Address Fax Number:
216-292-0033
Provider Enumeration Date:
01/08/2011

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:  I-0003528 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com