Provider Demographics
NPI:1134258510
Name:VELEDAR, HAMO (DDS)
Entity type:Individual
Prefix:
First Name:HAMO
Middle Name:
Last Name:VELEDAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 35TH ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-4730
Mailing Address - Country:US
Mailing Address - Phone:718-777-7667
Mailing Address - Fax:718-278-3260
Practice Address - Street 1:3006 34TH ST APT 2FL
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-5245
Practice Address - Country:US
Practice Address - Phone:718-278-3888
Practice Address - Fax:718-278-3260
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0508321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02413394Medicaid