Provider Demographics
NPI:1053568063
Name:VENERUSO, AUBRI S (MMS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:AUBRI
Middle Name:S
Last Name:VENERUSO
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:
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Mailing Address - Street 1:55 PALMER AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708
Mailing Address - Country:US
Mailing Address - Phone:914-787-3100
Mailing Address - Fax:914-787-3110
Practice Address - Street 1:55 PALMER AVENUE
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708
Practice Address - Country:US
Practice Address - Phone:914-787-3100
Practice Address - Fax:914-787-3110
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY019634363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant