Provider Demographics
NPI:1821021999
Name:VELIATH, GEORGE THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:THOMAS
Last Name:VELIATH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:60 PROSPECT AVE
Mailing Address - Street 2:RADIOLOGIC ASSOCIATES, PC
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4133
Mailing Address - Country:US
Mailing Address - Phone:845-343-0616
Mailing Address - Fax:845-343-0617
Practice Address - Street 1:60 PROSPECT AVE
Practice Address - Street 2:RADIOLOGIC ASSOCIATES, PC
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4133
Practice Address - Country:US
Practice Address - Phone:845-343-0616
Practice Address - Fax:845-343-0617
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2009-12-02
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY111633207U00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02660153Medicaid
NY02660153Medicaid
NY770S51Medicare ID - Type Unspecified