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General NPI Number Information
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NPI Number | 1265390744
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Entity Type | Organization
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Legal Business Name | VENTURE MEDICAL
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 20 GILBERT AVE STE 102A
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City | SMITHTOWN
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State | NY
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Zip | 11787-5326
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Country | US
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Telephone | 631-888-3168
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Fax | 877-395-5429
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Provider Business Mailing Address
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Address Line | 24 WILMINGTON DR
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City | MELVILLE
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State | NY
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Zip | 11747-4026
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Country | US
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Telephone | 631-888-3168
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Fax | 877-395-5429
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Authorized Official
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Title or Position | OWNER
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Name | CRAIG GROBMAN
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Credential | MD
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Telephone | 631-888-3168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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