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General NPI Number Information
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NPI Number | 1386767721
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Entity Type | Individual
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Provider Name | BENJAMIN ROBERT VENA CNMT, RT(N)
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3289 WOODBURN RD SUITE 060
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City | ANNANDALE
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State | VA
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Zip | 22003-6800
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Country | US
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Telephone | 703-698-0666
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Fax |
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Provider Business Mailing Address
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Address Line | 2766 STONE HOLLOW DR
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City | VIENNA
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State | VA
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Zip | 22180-7072
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Country | US
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Telephone | 312-405-8820
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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 | 2471N0900X
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Taxonomy Name | Nuclear Medicine Technology Radiologic Technologist
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License Number | NA
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License Number State | VA
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