Provider Demographics
NPI:1548274442
Name:VENUTI, ROBERT LOUIS (DO)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LOUIS
Last Name:VENUTI
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:188 FRIES MILL ROAD
Mailing Address - Street 2:N 3
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-8319
Mailing Address - Country:US
Mailing Address - Phone:856-875-8000
Mailing Address - Fax:856-875-8494
Practice Address - Street 1:188 FRIES MILL ROAD
Practice Address - Street 2:N 3
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-8319
Practice Address - Country:US
Practice Address - Phone:856-875-8000
Practice Address - Fax:856-875-8494
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-08-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMB48471207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C54387Medicare UPIN