Provider Demographics
NPI:1528417961
Name:VELOSO, KAREN GRACE (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:GRACE
Last Name:VELOSO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN GRACE
Other - Middle Name:
Other - Last Name:VELOSO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:355 BARD AVE
Mailing Address - Street 2:DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1664
Mailing Address - Country:US
Mailing Address - Phone:718-818-2419
Mailing Address - Fax:
Practice Address - Street 1:355 BARD AVE
Practice Address - Street 2:DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1664
Practice Address - Country:US
Practice Address - Phone:718-818-2419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299850208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist