Provider Demographics
NPI:1467676247
Name:VELKOFF, CYRIL TOWNSEND (MS)
Entity Type:Individual
Prefix:MR
First Name:CYRIL
Middle Name:TOWNSEND
Last Name:VELKOFF
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 FOGELMAN RD
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-6811
Mailing Address - Country:US
Mailing Address - Phone:570-337-3320
Mailing Address - Fax:
Practice Address - Street 1:200 EAST ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6613
Practice Address - Country:US
Practice Address - Phone:570-337-3320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005208L103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPS005208LOtherLICENSED PSYCHOLOGIST