Provider Demographics
NPI:1437241593
Name:MINTZ-VELEZ, MELISSA ROSE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ROSE
Last Name:MINTZ-VELEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2385 ABERDEEN ST
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3006
Mailing Address - Country:US
Mailing Address - Phone:718-496-2455
Mailing Address - Fax:
Practice Address - Street 1:2385 ABERDEEN ST
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-3006
Practice Address - Country:US
Practice Address - Phone:718-496-2455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027968225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist