Velasco, Mauricio
Velasco, Mauricio is an sole proprietor health care provider with primary practice located at 6500 Broadway , West New York NJ 07093-3112. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Velasco, Mauricio can be contacted via phone (201) 864-3456.Contact Information
Primary practice address
6500 Broadway
West New York NJ 07093-3112
Phone: (201) 864-3456
Fax: (201) 869-7224
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 25MA07598200 | New Jersey |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2342401 | New York |
Profile Details
| NPI number | 1508848979 |
|---|---|
| LBN Legal business name | Velasco, Mauricio |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 18th, 2005 |
| Last updated | Oct 13th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508848979 | NPPES |
| New Jersey | MEDICAID | 0060437 |
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