Individual
DR. JUAN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17 NEWCASTLE CT, MOUNTAIN LAKES, NJ 07046-1450
(973) 625-4106
Mailing address
17 NEWCASTLE CT, MOUNTAIN LAKES, NJ 07046-1450
(973) 299-1961
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MA36433
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1704702
—
NJ
Enumeration date
11/24/2006
Last updated
07/12/2017
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