Individual
SANDRA J VELAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEDIATRIC NP
Contact information
Practice address
26 QUEEN ST, MEDICAL, WORCESTER, MA 01610-2473
(508) 860-7700
(508) 860-7990
Mailing address
26 QUEEN ST, MEDICAL, WORCESTER, MA 01610-2473
(508) 860-7700
(508) 860-7990
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
175591
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0029009
NHP
MA
01
—
1300709
CMSP
MA
05
—
1300709
—
MA
01
—
47954
FALLON SELECT
MA
01
—
NP1925
BCBS
MA
01
—
Y10141
BCBS-GROUP
MA
Enumeration date
08/09/2006
Last updated
07/09/2007
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