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General NPI Number Information
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NPI Number | 1356659957
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Entity Type | Individual
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Provider Name | VENISE A CAMERON FNP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 111 E 210TH ST
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City | BRONX
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State | NY
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Zip | 10467-2401
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Country | US
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Telephone | 718-920-4321
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Fax |
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Provider Business Mailing Address
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Address Line | 169 BELMONT BLVD
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City | ELMONT
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State | NY
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Zip | 11003-2202
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Country | US
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Telephone | 347-229-2719
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 608008
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 340194
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F340194
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License Number State | NY
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