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Individual
LISA VENUTO
Active
Individual
LISA VENUTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026799601
EXCELLUS UNIVERA
NY
01
—
005702421
HEALTH NOW
NY
05
—
01988334
—
NY
01
—
9512092
INDEPENDENT HEALTH
NY
Enumeration date
07/07/2006
Last updated
11/23/2011
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