Individual
DIANE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
250 RIVER ST, HACKENSACK, NJ 07601-7514
(201) 820-3730
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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