Provider Demographics
NPI:1699549816
Name:PROVENTUS PC
Entity type:Organization
Organization Name:PROVENTUS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZZOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-578-8080
Mailing Address - Street 1:111 WADSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6102
Mailing Address - Country:US
Mailing Address - Phone:561-578-8400
Mailing Address - Fax:
Practice Address - Street 1:111 WADSWORTH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6102
Practice Address - Country:US
Practice Address - Phone:561-578-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty