1235297888 NPI number — MRS. ERIKA KARIN VELEZ PT, DPT

Table of content: MRS. ERIKA KARIN VELEZ PT, DPT (NPI 1235297888)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235297888 NPI number — MRS. ERIKA KARIN VELEZ PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VELEZ
Provider First Name:
ERIKA
Provider Middle Name:
KARIN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MESENBOURG
Provider Other First Name:
ERIKA
Provider Other Middle Name:
KARIN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235297888
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6410 DOBBIN ROAD
Provider Second Line Business Mailing Address:
SUITE G
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-917-2951
Provider Business Mailing Address Fax Number:
443-864-5296

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6410 DOBBIN ROAD
Provider Second Line Business Practice Location Address:
SUITE G
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-917-2951
Provider Business Practice Location Address Fax Number:
443-864-5296
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2305204014 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 25473 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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