Individual
SUSAN KO-VELEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
941 RTE 35, MIDDLETOWN, NJ 07748-2601
(732) 264-6070
Mailing address
941 RTE 35, MIDDLETOWN, NJ 07748-2601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00484700
NJ
Other
Enumeration date
04/19/2018
Last updated
06/11/2019
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