Provider Demographics
NPI:1639392855
Name:VELEZ, MELISSA (RPA-C)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:VELEZ
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 7TH AVE STE 4A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3691
Mailing Address - Country:US
Mailing Address - Phone:718-246-8614
Mailing Address - Fax:
Practice Address - Street 1:263 7TH AVE STE 4A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3691
Practice Address - Country:US
Practice Address - Phone:718-246-8614
Practice Address - Fax:718-246-8592
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011312363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant