Individual
ANABELL MARINA LOPEZ PLAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 BERRYWOOD CT, BAY SHORE, NY 11706-2058
(631) 882-3434
Mailing address
12 BERRYWOOD CT, BAY SHORE, NY 11706-2058
(631) 882-3434
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
024737
NY
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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