Healthcare Provider Details

I. General information

NPI: 1114193190
Provider Name (Legal Business Name): EDNA VELEZ APN,C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 GRAND ST
HOBOKEN NJ
07030-2510
US

IV. Provider business mailing address

104 NORTH ST
JERSEY CITY NJ
07307-2551
US

V. Phone/Fax

Practice location:
  • Phone: 201-963-0300
  • Fax: 201-963-0303
Mailing address:
  • Phone: 201-798-2489
  • Fax: 201-963-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SW0102X
TaxonomyWomen's Health Clinical Nurse Specialist
License Number26NN08385000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: