Individual
LISETTE VELASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13411 KEW GARDENS RD, RICHMOND HILL, NY 11418-1930
(718) 441-0155
(718) 850-4720
Mailing address
16312 43RD AVE, FLUSHING, NY 11358-2614
(347) 520-9592
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52930507
SERVICE COORDINATOR
NY
Enumeration date
01/17/2020
Last updated
01/17/2020
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