Provider Demographics
NPI:1710295662
Name:VELASQUEZ, MARGARITA ROSA (MA CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:MARGARITA
Middle Name:ROSA
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 12TH ST APT 1F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-1960
Mailing Address - Country:US
Mailing Address - Phone:917-593-6437
Mailing Address - Fax:
Practice Address - Street 1:300 W 12TH ST APT 1F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-1960
Practice Address - Country:US
Practice Address - Phone:917-593-6437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006101-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist