Individual
CANDICE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
211 E 51ST ST, NEW YORK, NY 10022-6526
(212) 906-7798
Mailing address
211 E 51ST ST, NEW YORK, NY 10022-6526
(212) 906-7798
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025846
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2020
Last updated
01/13/2021
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