Individual
ISMARIE VELAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E 210TH ST, MONTEFIORE MEDICAL CENTER DEPT OF DENTISTRY, BRONX, NY 10467-2401
(718) 920-6039
Mailing address
540 CARR 112, ISABELA, PR 00662
(787) 552-0053
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
058735
NY
Other
Enumeration date
04/09/2015
Last updated
07/17/2017
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