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General NPI Number Information
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NPI Number | 1487366241
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Entity Type | Individual
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Provider Name | STEPHANIE VELASQUEZ
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Gender | Female
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Dates
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Enumeration Date | 12/22/2022
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Last Update Date | 01/24/2026
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Provider Practice Location Address
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Address Line | 888 VETERANS HWY STE 310
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City | HAUPPAUGE
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State | NY
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Zip | 11788-2940
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Country | US
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Telephone | 631-851-9473
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Fax |
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Provider Business Mailing Address
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Address Line | 7525 153RD ST APT PH04
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City | KEW GARDENS HILLS
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State | NY
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Zip | 11367-3090
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Country | US
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Telephone | 609-731-5215
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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 |
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