Healthcare Provider Details

I. General information

NPI: 1841114063
Provider Name (Legal Business Name): DEYANIRA VELOZNUNEZ M.ED., M.A., ED.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BROADWAY
BAYONNE NJ
07002-3712
US

IV. Provider business mailing address

PO BOX 626
NEW PROVIDENCE NJ
07974-0626
US

V. Phone/Fax

Practice location:
  • Phone: 201-455-2052
  • Fax: 201-354-9376
Mailing address:
  • Phone: 201-455-2052
  • Fax: 201-354-9376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37AC00987400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: