MEDICARE: DR. JAMES THOMAS VENTRESCA D.O.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	20	MA
2	171100000X	Acupuncturist	372	NM

General Provider Information

NPI Number	:	1730225293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES THOMAS VENTRESCA D.O.M.

Provider Business Mailing Address
First Line	:	PO BOX 1291
Second Line	:
City	:	TIJERAS
State	:	NM
Zip	:	87059-1291
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7120 4TH ST NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-6642
Country	:	US
Telephone Number	:	505-259-5928
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. JAMES THOMAS VENTRESCA D.O.M.” Practice Location

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