Jason Velazquez
Individual provider Active NPI Speech-Language Pathologist · Brightwaters, NY
NPI 1275948689 · NPPES record last updated Jun 24, 2014
Key facts
- NPI
- 1275948689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 0233791 (NY)
- Practice address
- 487 Richland Blvd
Brightwaters, NY 11718-1221 - Phone
- (631) 849-6499
- NPI assigned
- Jun 24, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0233791 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 0233791 | NY | Yes |
Addresses
Primary practice location
487 Richland Blvd
Brightwaters, NY 11718-1221
Mailing address
487 Richland Blvd
Brightwaters, NY 11718-1221
Other providers in Brightwaters, NY
- Kristin Michelle Stawiarski
- Laura Thompson Steel
- Suffolk Gynecologic Oncology Management
- Sunshine Within Mental Health Counseling, PLLC
- Mabel Thomas
All providers in Brightwaters, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.