Provider Demographics
NPI:1093307290
Name:VELAZQUEZ, YAMILEX TORRES (OBAT NAVIGATOR)
Entity Type:Individual
Prefix:
First Name:YAMILEX
Middle Name:TORRES
Last Name:VELAZQUEZ
Suffix:
Gender:F
Credentials:OBAT NAVIGATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 PENNINGTON RD STE 1
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2669
Mailing Address - Country:US
Mailing Address - Phone:609-890-1050
Mailing Address - Fax:609-890-0950
Practice Address - Street 1:1440 PENNINGTON RD STE 1
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-2669
Practice Address - Country:US
Practice Address - Phone:609-890-1050
Practice Address - Fax:609-890-0950
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty