Individual
MR. JOSE RAFAEL BUENO VENTURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0001
(814) 877-2938
(814) 877-6070
Mailing address
217 E BROAD ST, BURLINGTON, NJ 08016-1722
(609) 356-9021
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN790353
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NR21099900
NJ RN MULTI STATE LICENSE
NJ
01
—
RN790353
PA RN LICENSE
PA
Enumeration date
10/24/2024
Last updated
10/24/2024
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