Provider Demographics
NPI:1093774804
Name:VELINOV, MILEN (MD PHD)
Entity Type:Individual
Prefix:
First Name:MILEN
Middle Name:
Last Name:VELINOV
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 829642
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-9642
Mailing Address - Country:US
Mailing Address - Phone:866-470-6626
Mailing Address - Fax:413-599-0470
Practice Address - Street 1:89 FRENCH ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1935
Practice Address - Country:US
Practice Address - Phone:732-235-9386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238087208000000X, 207SG0201X
NJ25MA11058100207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02554649Medicaid
NY2554649Medicaid
P3641517OtherOXFORD
7734837OtherAETNA
113538OtherGHI
1678160OtherCIGNA
236635OtherUNITED HEALTHCARE
000188480201OtherHEALTHPLUS
223810POtherHIP
5C4677OtherHEALTHNET
6B8931OtherEMPIRE BCBS
L18328Medicare UPIN
NY2554649Medicaid
NY02554649Medicaid
6889323311Medicare PIN