Individual
LUIS VELASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11449 SUTPHIN BLVD, JAMAICA, NY 11434-1022
(718) 723-4173
Mailing address
11449 SUTPHIN BLVD, JAMAICA, NY 11434-1022
(718) 945-7150
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
255407
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03267383
—
NY
Enumeration date
06/01/2010
Last updated
12/20/2011
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