Provider Demographics
NPI:1225657471
Name:VELONIAS, GABRIELLA M (OD)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:M
Last Name:VELONIAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-6712
Mailing Address - Country:US
Mailing Address - Phone:617-872-2177
Mailing Address - Fax:
Practice Address - Street 1:2261 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-6712
Practice Address - Country:US
Practice Address - Phone:617-872-2177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program