Active NPI
Eddie Venzor, PH. D.
- Clinical Psychologist
- Buffalo, NY
National Provider Identifier
1275545972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 007150-1
- Practice address
- 3495 Bailey Ave
Buffalo, NY 14215-1129 - Phone
- (716) 862-8595
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 007150-1 | NY | Primary |
Addresses
Primary practice location
3495 Bailey Ave
Buffalo, NY 14215-1129
Mailing address
39 Cortland Ave
Tonawanda, NY 14223-2027
Phone (716) 871-2430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007150-1 | NY | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275545972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 CORTLAND AVE",
"city": "TONAWANDA",
"state": "NY",
"postal_code": "142232027",
"telephone_number": "716-871-2430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3495 BAILEY AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142151129",
"telephone_number": "716-862-8595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENZOR",
"first_name": "EDDIE",
"name_prefix": "Dr.",
"credential": "PH. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "007150-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.