Provider Demographics
NPI:1548493703
Name:VELEZ, SARA M (PT, DPT, MS, ATC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:VELEZ
Suffix:
Gender:F
Credentials:PT, DPT, MS, ATC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:157 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1374
Mailing Address - Country:US
Mailing Address - Phone:551-497-3537
Mailing Address - Fax:
Practice Address - Street 1:100 PARK AVE STE 4
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642
Practice Address - Country:US
Practice Address - Phone:201-263-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01317100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ165809DBDOtherMEDICARE
NJ165809DBDOtherMEDICARE