Basic Information
| Provider Information | |||||||||
| NPI: | 1982797023 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VELLA | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 535 E CRESCENT AVE | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | RAMSEY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074462922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016617280 | ||||||||
| FaxNumber: | 2016617297 | ||||||||
| Practice Location | |||||||||
| Address1: | 70 HATFIELD LN | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | GOSHEN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109246734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456153320 | ||||||||
| FaxNumber: | 8452944366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 09/06/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 249157 | NY | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZP0102X | 25MA09050600 | NJ | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.