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Individual

ISAIAS LOPE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OPTICIAN

Contact information

Practice address
8325 37TH AVE, JACKSON HEIGHTS, NY 11372-7320
(718) 426-2725
(718) 426-9748
Mailing address
8325 37TH AVE, JACKSON HEIGHTS, NY 11372-7320
(718) 426-2725
(718) 426-9748

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
NY006945-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02220762
NY
Enumeration date
12/13/2007
Last updated
12/13/2007
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