Provider Demographics
NPI:1962767350
Name:VELA, MILUSKA T (SPECIALIST)
Entity type:Individual
Prefix:MISS
First Name:MILUSKA
Middle Name:T
Last Name:VELA
Suffix:
Gender:F
Credentials:SPECIALIST
Other - Prefix:MISS
Other - First Name:MILUSKA
Other - Middle Name:T
Other - Last Name:VELA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SPECIALIST
Mailing Address - Street 1:32-52 33ST AND 34AVE
Mailing Address - Street 2:B1
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106
Mailing Address - Country:US
Mailing Address - Phone:917-716-3533
Mailing Address - Fax:
Practice Address - Street 1:3252 33RD ST APT B1
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-2132
Practice Address - Country:US
Practice Address - Phone:917-716-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY600741121174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist