Individual
JEANNE MICHELLE VELASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1240 S BROAD ST STE 130, LANSDALE, PA 19446-5395
(215) 361-5040
Mailing address
401 ROUTE 73 N STE 320, MARLTON, NJ 08053-3426
(856) 872-7055
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD451816
PA
2080P0214X
Pediatric Pulmonology Physician
MD451816
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD451816
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
PA
Enumeration date
05/18/2010
Last updated
01/08/2024
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