Individual
JULISSA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
66 W GILBERT ST, TINTON FALLS, NJ 07701-4947
(732) 212-0060
Mailing address
50 KINROSS PL, YONKERS, NY 10703-2018
(646) 275-6599
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
348470
NY
Other
Enumeration date
12/20/2021
Last updated
02/22/2025
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