Provider Demographics
NPI:1881059293
Name:VELEKEI, TIMOTHY JAMES SR
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:VELEKEI
Suffix:SR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:TIMOTHY
Other - Middle Name:JAMES
Other - Last Name:VELEKEI
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:LO
Mailing Address - Street 1:455 BLUE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-1513
Mailing Address - Country:US
Mailing Address - Phone:610-452-2720
Mailing Address - Fax:610-452-2720
Practice Address - Street 1:455 BLUE VALLEY DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013
Practice Address - Country:US
Practice Address - Phone:610-432-7000
Practice Address - Fax:610-432-7000
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-30
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA046078156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician