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General NPI Number Information
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NPI Number | 1518039254
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Entity Type | Organization
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Legal Business Name | MANUEL VELAZQUEZ MD PC
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 250 E HOUSTON ST
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City | NEW YORK
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State | NY
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Zip | 10002-1034
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Country | US
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Telephone | 212-353-8314
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E 61ST ST APT 5G
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City | NEW YORK
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State | NY
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Zip | 10021-8550
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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 | SOLE PROPRIETOR
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Name | MANUEL VELAZQUEZ
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Credential |
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Telephone | 718-302-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 178765
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License Number State | NM
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