Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | 046351 | NY |
Y | 1223P0221X | Pediatric Dentist | 2276 | PR |
NPI | 1043314156 |
---|---|
Provider Name | Linda Enid Velez |
First Address | Ponce, PR 00732-0600 |
Second Address | Ponce, PR 00717-2113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 09/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01637498 | (05) | NY |