Provider Demographics
NPI:1437189073
Name:VELOCCI, JODI (PA)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:VELOCCI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:791N WELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757
Mailing Address - Country:US
Mailing Address - Phone:631-957-2200
Mailing Address - Fax:631-957-4619
Practice Address - Street 1:70 E SUNRISE HWY
Practice Address - Street 2:5TH FL.
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1233
Practice Address - Country:US
Practice Address - Phone:516-825-3600
Practice Address - Fax:516-823-2096
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY003499363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant