Individual
ANA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-0333
Mailing address
33 BAXTER AVE, NEW HYDE PARK, NY 11040-3956
(516) 513-2169
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1225089
NY
Other
Enumeration date
01/06/2025
Last updated
02/13/2025
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