Individual
DR. WYLIE Y LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2315 ROUTE 34, MANASQUAN, NJ 08736-1444
(732) 974-0404
(732) 449-4271
Mailing address
2315 ROUTE 34, MANASQUAN, NJ 08736-1444
(732) 974-0404
(732) 449-4271
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25MA11399800
NJ
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
25MA11399800
NJ
Other
Enumeration date
06/07/2016
Last updated
12/04/2024
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