Provider Demographics
NPI:1831463389
Name:VELEZ, IMANI ELLA (RN)
Entity Type:Individual
Prefix:
First Name:IMANI
Middle Name:ELLA
Last Name:VELEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 KENTUCKY XING
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3239
Mailing Address - Country:US
Mailing Address - Phone:585-201-2458
Mailing Address - Fax:
Practice Address - Street 1:331 KENTUCKY XING
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3239
Practice Address - Country:US
Practice Address - Phone:585-201-2458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2021-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN217545163W00000X
NY645169163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse