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Individual

ELIJAH J VENTURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
EMT

Contact information

Practice address
71 SAGE AVE, UPPER, BUFFALO, NY 14210
(716) 946-3814
Mailing address
71 SAGE AVE UPPR, BUFFALO, NY 14210-1821
(716) 946-3814

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
441044
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
441044
EMT
NY
Enumeration date
07/31/2017
Last updated
07/31/2017
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