Provider Demographics
NPI:1083937221
Name:MARTE-VELEZ, MYRIAM E (DC)
Entity Type:Individual
Prefix:DR
First Name:MYRIAM
Middle Name:E
Last Name:MARTE-VELEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MYRIAM
Other - Middle Name:ESTHER
Other - Last Name:VELEZ HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:500 HELENDALE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-3173
Mailing Address - Country:US
Mailing Address - Phone:585-654-6670
Mailing Address - Fax:585-654-6567
Practice Address - Street 1:500 HELENDALE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-3173
Practice Address - Country:US
Practice Address - Phone:585-654-6670
Practice Address - Fax:585-654-6567
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY70011820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
J400022388Medicare UPIN