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General NPI Number Information
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NPI Number | 1750554705
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Entity Type | Organization
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Legal Business Name | MIODRAG VELICKOVIC, M.D. P.C.
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 11/27/2008
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Provider Practice Location Address
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Address Line | 1940 COMMERCE ST #107
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-4428
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Country | US
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Telephone | 914-962-1000
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Fax | 914-962-8267
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Provider Business Mailing Address
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Address Line | 1940 COMMERCE ST #107
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-4428
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Country | US
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Telephone | 914-962-1000
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Fax | 914-962-8267
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIODRAG VELICKOVIC
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Credential |
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Telephone | 914-962-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 222598
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License Number State | NY
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