Provider Demographics
NPI:1114193190
Name:VELEZ, EDNA (APN,C)
Entity Type:Individual
Prefix:
First Name:EDNA
Middle Name:
Last Name:VELEZ
Suffix:
Gender:F
Credentials:APN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-2551
Mailing Address - Country:US
Mailing Address - Phone:201-798-2489
Mailing Address - Fax:201-963-0303
Practice Address - Street 1:124 GRAND ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2510
Practice Address - Country:US
Practice Address - Phone:201-963-0300
Practice Address - Fax:201-963-0303
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08385000364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health