Provider Demographics
NPI:1235297888
Name:VELEZ, ERIKA KARIN (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:KARIN
Last Name:VELEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:KARIN
Other - Last Name:MESENBOURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6410 DOBBIN ROAD
Mailing Address - Street 2:SUITE G
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045
Mailing Address - Country:US
Mailing Address - Phone:443-917-2951
Mailing Address - Fax:443-864-5296
Practice Address - Street 1:6410 DOBBIN ROAD
Practice Address - Street 2:SUITE G
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045
Practice Address - Country:US
Practice Address - Phone:443-917-2951
Practice Address - Fax:443-864-5296
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204014225100000X
MD25473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0326830Medicare ID - Type Unspecified