Provider Demographics
NPI:1376630798
Name:VELLA, LOUIS
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:VELLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2176 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1805
Mailing Address - Country:US
Mailing Address - Phone:718-726-5454
Mailing Address - Fax:718-726-5186
Practice Address - Street 1:2176 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-1805
Practice Address - Country:US
Practice Address - Phone:718-726-5454
Practice Address - Fax:718-726-5186
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0042796OtherGHI PROVIDER #
NYP520550OtherOXFORD PROVIDER #
NY0042796OtherGHI PROVIDER #
NYP520550OtherOXFORD PROVIDER #