Provider Demographics
NPI:1982797023
Name:VELLA, JOSEPH MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:VELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:535 E CRESCENT AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2922
Mailing Address - Country:US
Mailing Address - Phone:201-661-7280
Mailing Address - Fax:201-661-7297
Practice Address - Street 1:70 HATFIELD LN
Practice Address - Street 2:SUITE 205
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-6734
Practice Address - Country:US
Practice Address - Phone:845-615-3320
Practice Address - Fax:845-294-4366
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY249157207ZP0102X
NJ25MA09050600207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400049848Medicare PIN