MEDICARE: LINDA VELAZQUEZ PHARMD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI03229300	NJ

General Provider Information

NPI Number	:	1336468594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA VELAZQUEZ PHARMD.

Provider Business Mailing Address
First Line	:	144 34TH ST APT 2
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-5903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	543 RIVER RD
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1146
Country	:	US
Telephone Number	:	201-402-0253
Fax Number	:	201-402-0253

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2010
Last Update Date	:	05/26/2010

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Directions to “ LINDA VELAZQUEZ PHARMD.” Practice Location

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