Provider Demographics
NPI:1417047200
Name:VELAZQUEZ, BELINDA MELISSA (MD)
Entity Type:Individual
Prefix:MS
First Name:BELINDA
Middle Name:MELISSA
Last Name:VELAZQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 GRAMERCY PARK N STE 1M
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5423
Mailing Address - Country:US
Mailing Address - Phone:212-260-7337
Mailing Address - Fax:212-260-7177
Practice Address - Street 1:60 GRAMERCY PARK N STE 1M
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5423
Practice Address - Country:US
Practice Address - Phone:212-260-7337
Practice Address - Fax:212-260-7177
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197524174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01524809Medicaid
NY01524809Medicaid