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General NPI Number Information
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NPI Number | 1134954548
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Entity Type | Individual
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Provider Name | KAREN VELASQUEZ M.A.
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Gender | Female
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 400 S OYSTER BAY RD STE 102
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City | HICKSVILLE
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State | NY
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Zip | 11801-3500
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Country | US
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Telephone | 631-240-3579
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Fax |
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Provider Business Mailing Address
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Address Line | 8710 37TH AVE APT 402
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7743
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Country | US
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Telephone | 929-264-8789
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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