Provider Demographics
NPI:1386425791
Name:CASARENO, VENUS N
Entity type:Individual
Prefix:MS
First Name:VENUS
Middle Name:N
Last Name:CASARENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 RIVERFRONT BLVD APT 1419
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-1670
Mailing Address - Country:US
Mailing Address - Phone:551-574-2454
Mailing Address - Fax:
Practice Address - Street 1:300 RIVERFRONT BLVD APT 1419
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-1670
Practice Address - Country:US
Practice Address - Phone:551-574-2454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP06761800164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse