Healthcare Provider Details

I. General information

NPI: 1033597786
Provider Name (Legal Business Name): ROBERT VENUTI CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 09/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CLEARBROOK LN
SEWELL NJ
08080-3320
US

IV. Provider business mailing address

26 CLEARBROOK LN
SEWELL NJ
08080-3320
US

V. Phone/Fax

Practice location:
  • Phone: 856-875-8000
  • Fax:
Mailing address:
  • Phone: 856-875-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB04847100
License Number StateNJ

VIII. Authorized Official

Name: DR. ROBERT L VENUTI
Title or Position: OWNER/PHYSICIAN
Credential: D.O.
Phone: 856-875-8000