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General NPI Number Information
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NPI Number | 1285303214
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Entity Type | Individual
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Provider Name | AYENALIZ VELASQUEZ LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 257 STANWICH RD
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City | GREENWICH
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State | CT
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Zip | 06830-3501
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Country | US
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Telephone | 914-844-2503
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Fax |
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Provider Business Mailing Address
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Address Line | 32 CESARIO PL FL 1
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City | PORT CHESTER
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State | NY
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Zip | 10573-5102
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Country | US
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Telephone |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 001943
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License Number State | CT
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