Provider Demographics
NPI:1669578910
Name:VELEZ, CORAZON SUAREZ (MD)
Entity type:Individual
Prefix:DR
First Name:CORAZON
Middle Name:SUAREZ
Last Name:VELEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CORAZON
Other - Middle Name:S
Other - Last Name:VELEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1000 WEST MAIN STREET
Mailing Address - Street 2:MEDICAL SPECIALISTS ASSOCIATES, P.A.
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:732-431-1686
Mailing Address - Fax:732-845-3350
Practice Address - Street 1:1000 WEST MAIN STREET
Practice Address - Street 2:MEDICAL SPECIALISTS ASSOCIATES, P.A.
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-431-1686
Practice Address - Fax:732-845-3350
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02844800208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA02844800OtherLLCENSE
NJC55466Medicare UPIN