Provider Demographics
NPI:1306448071
Name:AVEL PT SERVICES
Entity type:Organization
Organization Name:AVEL PT SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEDNITSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CSCS,CEAS
Authorized Official - Phone:201-455-7858
Mailing Address - Street 1:449 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-5105
Mailing Address - Country:US
Mailing Address - Phone:201-455-7858
Mailing Address - Fax:201-243-9898
Practice Address - Street 1:449 AVENUE C
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-5105
Practice Address - Country:US
Practice Address - Phone:732-485-2876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy