MEDICARE: GABRIEL ANTHONY VELEZ JR.

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	367500000X	Certified Registered Nurse Anesthetist	RN719962	PA

General Provider Information

NPI Number	:	1790467330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL ANTHONY VELEZ JR.

Provider Business Mailing Address
First Line	:	24 S 18TH ST
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18104-5622
Country	:	US
Telephone Number	:	610-628-8372
Fax Number	:	610-628-8648

Provider Business Practice Location Address
First Line	:	1200 S CEDAR CREST BLVD FL 2
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18103-6202
Country	:	US
Telephone Number	:	610-402-6164
Fax Number	:

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

Provider Enumeration Date	:	08/03/2023
Last Update Date	:	01/27/2026

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