Provider Demographics
NPI:1053593863
Name:VELEAS, LEO M (DPM)
Entity type:Individual
Prefix:DR
First Name:LEO
Middle Name:M
Last Name:VELEAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2525
Mailing Address - Country:US
Mailing Address - Phone:860-621-6828
Mailing Address - Fax:860-621-6820
Practice Address - Street 1:221 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2525
Practice Address - Country:US
Practice Address - Phone:860-621-6828
Practice Address - Fax:860-621-6820
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000213213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT500000213CT01OtherANTHEM BC/BS
CT0159439001OtherCIGNA
CT021300OtherCONNECTICARE
CTHAS029OtherOXFORD
CTHAS029OtherOXFORD