| Doctor Name: | NANCY VENDURA |
| NPI Number: | 1184716987 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PNP |
| License Number: | F380948 |
| Business Practice Address: | 99 Cameron St Pine Bush, NY - 125667113 |
| Business Phone Number: | 8453437614 |
| Business Fax Number: | 8453435390 |
| Mailing Address: | 21 Orchard St, Po Box 987 MIDDLETOWN |
| State: | NY |
| Postal Code: | 109405004 |
| Phone Number: | 8453437614 |
| Fax Number: | 8453435390 |
| NPI Enumeration Date: | 09/29/2006 |
| NPI Last Update Date: | 08/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | F380948 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |