Individual
EDWARD ANDRES LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
14015 SANFORD AVE STE B, FLUSHING, NY 11355-2688
(718) 358-5265
Mailing address
6154 70TH ST FL 2, MIDDLE VILLAGE, NY 11379-1212
(646) 251-2958
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
613945
NY
Other
Enumeration date
04/08/2020
Last updated
04/09/2020
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