Individual
ANGELA LOPEZ SAN JOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1765 BROADWAY, BROOKLYN, NY 11207-1611
(347) 605-8261
Mailing address
4150 78TH ST APT 514, ELMHURST, NY 11373-1919
(347) 605-8261
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
32276
NY
Other
Enumeration date
01/08/2013
Last updated
01/08/2013
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