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
Fax: (201) 869-7224
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508848979 NPPES
New Jersey MEDICAID 0060437

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