Individual
JOMARA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5032 31ST AVE, APT. 4D, WOODSIDE, NY 11377-1361
(718) 853-9700
(347) 390-8214
Mailing address
5032 31ST AVE, APT. 4D, WOODSIDE, NY 11377-1361
(718) 853-9700
(347) 390-8214
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
233483102
NY
Other
Enumeration date
11/27/2013
Last updated
11/27/2013
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