Individual
ELEONORA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 GLEN COVE AVE, NORTH COAST MEDICAL GROUP, SEA CLIFF, NY 11579-1455
(516) 676-1742
(516) 676-9662
Mailing address
207 GLEN COVE AVE, NORTH COAST MEDICAL GROUP, SEA CLIFF, NY 11579-1455
(516) 676-1742
(516) 676-9662
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
30 307218
NY
363LG0600X
Gerontology Nurse Practitioner
30 307218
NY
Other
Enumeration date
02/01/2016
Last updated
03/07/2017
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