Individual
MARY G. LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
554 LARKFIELD RD, SUITE 105, EAST NORTHPORT, NY 11731-4205
(631) 368-3800
(631) 368-3802
Mailing address
554 LARKFIELD RD, SUITE 105, EAST NORTHPORT, NY 11731-4205
(631) 368-3800
(631) 368-3802
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F420526
NY
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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