Provider Demographics
NPI:1205095486
Name:VELEZ, NICOLE F (MD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:F
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 1:144 EMERYVILLE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5015
Mailing Address - Country:US
Mailing Address - Phone:412-206-2966
Mailing Address - Fax:412-206-2966
Practice Address - Street 1:144 EMERYVILLE DR STE 230
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-5015
Practice Address - Country:US
Practice Address - Phone:412-206-2966
Practice Address - Fax:412-206-2966
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD451018207N00000X, 207ND0900X, 207NS0135X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA12596642OtherCAQH
PA1029155970003Medicaid