Individual
GRACE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
2201 HEMPSTEAD TPKE, NASSAU UNIVERSITY MEDICAL CENTER, EAST MEADOW, NY 11554-1859
(516) 572-6131
Mailing address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
005013
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005013
NY STATE LICENSE NUMBER
NY
Enumeration date
05/15/2007
Last updated
07/08/2007
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