Individual
BRYAN VELEZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
646 COMMACK RD, COMMACK, NY 11725-5426
(631) 499-4114
Mailing address
646 COMMACK RD, COMMACK, NY 11725-5426
(631) 499-4114
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
22288
PR
208000000X
Pediatrics Physician
Primary
330215
NY
Other
Enumeration date
07/12/2017
Last updated
12/13/2024
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