Individual
GERARDO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 W 34TH ST RM 204, NEW YORK, NY 10001-3011
(212) 600-4808
Mailing address
PO BOX 1076, NEW YORK, NY 10116-1076
(646) 425-6305
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
009218-1
NY
Other
Enumeration date
06/20/2021
Last updated
06/20/2021
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