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Individual

ANTONIO D.S. LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
52 WASHINGTON AVE, SUITE 4, NORTH HAVEN, CT 06473-1724
(203) 672-2800
(203) 672-2801
Mailing address
52 WASHINGTON AVE, SUITE 4, NORTH HAVEN, CT 06473-1724
(203) 672-2800
(203) 672-2801

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
036552
CT
207R00000X
Internal Medicine Physician
Primary
036552
CT
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
036552
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004212932
CT
Enumeration date
01/19/2006
Last updated
11/06/2012
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