Provider Demographics
NPI:1174963870
Name:VELEZ-MILGLIORE, MELISA AWILDA
Entity type:Individual
Prefix:
First Name:MELISA
Middle Name:AWILDA
Last Name:VELEZ-MILGLIORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISA
Other - Middle Name:AWILDA
Other - Last Name:VELEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 N BROADWAY
Mailing Address - Street 2:APT. 16D
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-1239
Mailing Address - Country:US
Mailing Address - Phone:914-705-1812
Mailing Address - Fax:
Practice Address - Street 1:120 N BROADWAY
Practice Address - Street 2:APT. 16D
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533-1239
Practice Address - Country:US
Practice Address - Phone:914-705-1812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator