MEDICARE: MRS. SUZANNE LYNN VELEZ-PEREZ OTR/L

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	225X00000X	Occupational Therapist	003658-1	NY

General Provider Information

NPI Number	:	1851583959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUZANNE LYNN VELEZ-PEREZ OTR/L

Provider Business Mailing Address
First Line	:	700 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-2634
Country	:	US
Telephone Number	:	718-518-8892
Fax Number	:	718-931-5530

Provider Business Practice Location Address
First Line	:	700 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-2634
Country	:	US
Telephone Number	:	718-518-8892
Fax Number	:	718-931-5530

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

Provider Enumeration Date	:	08/13/2007
Last Update Date	:	08/13/2007

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