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General NPI Number Information
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NPI Number | 1831915859
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Entity Type | Individual
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Provider Name | WILLBER ALEXANDER VELASQUEZ RPH
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Gender | Male
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 5125 MERRICK RD
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-3728
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Country | US
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Telephone | 516-798-7676
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Fax |
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Provider Business Mailing Address
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Address Line | 1845 BROWNING ST
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-2321
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Country | US
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Telephone | 516-315-9676
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 072122
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License Number State | NY
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