Provider Demographics
NPI:1790224020
Name:VELASQUEZ, ONEIDY
Entity Type:Individual
Prefix:
First Name:ONEIDY
Middle Name:
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 E JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3196
Mailing Address - Country:US
Mailing Address - Phone:516-385-8044
Mailing Address - Fax:516-706-1740
Practice Address - Street 1:39 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3196
Practice Address - Country:US
Practice Address - Phone:516-385-8044
Practice Address - Fax:516-706-1740
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator