Provider Demographics
NPI:1326785569
Name:VELEZ, DENISSE V (DPM)
Entity type:Individual
Prefix:
First Name:DENISSE
Middle Name:V
Last Name:VELEZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1761
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-0761
Mailing Address - Country:US
Mailing Address - Phone:570-288-8881
Mailing Address - Fax:
Practice Address - Street 1:201 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-1509
Practice Address - Country:US
Practice Address - Phone:570-283-3222
Practice Address - Fax:877-231-0567
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC007539213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist