Individual
JOEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1071 MIRABELLE AVE, WESTBURY, NY 11590-5523
(516) 248-2415
(514) 248-2415
Mailing address
1071 MIRABELLE AVE, WESTBURY, NY 11590-5523
(516) 248-2415
(514) 248-2415
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
362248072
NY
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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