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General NPI Number Information
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NPI Number | 1528123403
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Entity Type | Organization
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Legal Business Name | MICHELLE L. VENEZIANO, O.D. INC.
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 01/30/2009
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Provider Practice Location Address
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Address Line | 3045 NOE BIXBY RD
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City | COLUMBUS
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State | OH
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Zip | 43232-5851
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Country | US
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Telephone | 614-837-3797
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Fax | 614-837-9494
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Provider Business Mailing Address
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Address Line | 3045 NOE BIXBY RD
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City | COLUMBUS
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State | OH
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Zip | 43232-5851
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Country | US
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Telephone | 614-837-3797
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Fax | 614-837-9494
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MICHELLE L VENEZIANO
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Credential | O.D.
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Telephone | 614-837-3797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 25-299822
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5344
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License Number State | OH
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