Provider Demographics
NPI:1902479918
Name:VENUTO, THOMAS MICHAEL (RN)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:MICHAEL
Last Name:VENUTO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 W HERSCHEL ST
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08215-3512
Mailing Address - Country:US
Mailing Address - Phone:609-412-4644
Mailing Address - Fax:609-593-6061
Practice Address - Street 1:427 W HERSCHEL ST
Practice Address - Street 2:
Practice Address - City:EGG HARBOR CITY
Practice Address - State:NJ
Practice Address - Zip Code:08215-3512
Practice Address - Country:US
Practice Address - Phone:609-412-4644
Practice Address - Fax:609-593-6061
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR11698200163W00000X, 163WD1100X, 163WH0200X, 163WI0500X, 163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163W00000XNursing Service ProvidersRegistered Nurse
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy