Individual
DR. JACOB J VENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
CHA - PSYCHIATRY - ADOLESCENT ASSESSMENT UNIT, 1493 CAMBRIDGE STREET, CAMBRIDGE, MA 02139
(617) 575-5460
Mailing address
CHA - PSYCHIATRY - ADOLESCENT ASSESSMENT UNIT, 1493 CAMBRIDGE STREET, CAMBRIDGE, MA 02139
(617) 575-5460
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
210085
MA
2084P0804X
Child & Adolescent Psychiatry Physician
32812
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110034921A
—
MA
01
—
459239
TUFTS HEALTH PLAN
MA
01
—
J25693
BCBS MA
MA
01
—
S400413978
MEDICARE
MA
Enumeration date
10/27/2005
Last updated
08/04/2020
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