Healthcare Provider Details

I. General information

NPI: 1932572559
Provider Name (Legal Business Name): DEBORAH VENTURA-TRAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2015
Last Update Date: 11/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3589 BIG RIDGE RD
SPENCERPORT NY
14559-1709
US

IV. Provider business mailing address

3599 BIG RIDGE RD
SPENCERPORT NY
14559-1709
US

V. Phone/Fax

Practice location:
  • Phone: 585-352-2460
  • Fax: 585-352-2688
Mailing address:
  • Phone: 585-352-2460
  • Fax: 585-352-2688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number681834
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: