Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 111634 | NY |
NPI | 1033189675 |
---|---|
Provider Name | Dr. Manuel A Veloso JR. |
First Address | Long Beach, NY 11561-3600 |
Second Address | Long Beach, NY 11561-3600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 18/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B78033 | (02) | NY |