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Organization
GREAT LAKES NP OF PSYCHIATRY, PLLC
Active
Organization
GREAT LAKES NP OF PSYCHIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORRAINE A. LOPEZ PMHNP (OWNER)
(716) 908-1711
Entity
Organization
Contact information
Practice address
3802 SENECA ST, WEST SENECA, NY 14224-3433
(716) 677-5418
Mailing address
PO BOX 61, EAST AMHERST, NY 14051-0061
(716) 908-1711
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400896
NY
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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