Healthcare Provider Details

I. General information

NPI: 1033615851
Provider Name (Legal Business Name): DANIEL PAUL VENNERO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KENMORE MERCY HOSPITAL 2950 ELMWOOD AVENUE
BUFFALO NY
14217
US

IV. Provider business mailing address

95 LEMOINE AVE
CHEEKTOWAGA NY
14227-1012
US

V. Phone/Fax

Practice location:
  • Phone: 716-447-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number022459
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: