Provider Demographics
NPI:1992194906
Name:VELEZ, ISABEL ODEIDA (MD)
Entity Type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:ODEIDA
Last Name:VELEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SANDERS PL
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-1211
Mailing Address - Country:US
Mailing Address - Phone:201-936-9660
Mailing Address - Fax:
Practice Address - Street 1:12-15 BROADWAY STE 2A
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2031
Practice Address - Country:US
Practice Address - Phone:201-936-9660
Practice Address - Fax:478-202-9392
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-14
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296016-1208000000X
NJ25MA10374000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics