Healthcare Provider Details

I. General information

NPI: 1841302387
Provider Name (Legal Business Name): DAVID M. VENESY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAHEY CLINIC CARDIOLOGY -5 E 41 MALL ROAD
BURLINGTON MA
01805
US

IV. Provider business mailing address

LAHEY CLINIC CARDIOLOGY -5 E 41 MALL ROAD
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-8002
  • Fax: 781-744-5261
Mailing address:
  • Phone: 781-744-8002
  • Fax: 781-744-5261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number208219
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number208219
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number208219
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: