Provider Demographics
NPI:1023262342
Name:NATALIE VELAZQUEZ OD AND ASSOCIATES INC
Entity type:Organization
Organization Name:NATALIE VELAZQUEZ OD AND ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-778-4662
Mailing Address - Street 1:222 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-5524
Mailing Address - Country:US
Mailing Address - Phone:973-778-4662
Mailing Address - Fax:973-778-3427
Practice Address - Street 1:222 MAIN AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5524
Practice Address - Country:US
Practice Address - Phone:973-778-4662
Practice Address - Fax:973-778-3427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ156359Medicare UPIN