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NPI Code Detail

MEDICARE: DR. JAMES THOMAS VENTRESCA D.O.M.

MEDICARE:  DR. JAMES THOMAS VENTRESCA  D.O.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist20MA
2171100000XAcupuncturist372NM

General Provider Information

NPI Number : 1730225293
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES THOMAS VENTRESCA D.O.M.
Provider Business Mailing Address
First Line : PO BOX 1291
Second Line :
City : TIJERAS
State : NM
Zip : 87059-1291
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7120 4TH ST NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87107-6642
Country : US
Telephone Number : 505-259-5928
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JAMES THOMAS VENTRESCA D.O.M.” Practice Location

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