Individual
DR. MANUEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9033 SPRINGFIELD BLVD, QUEENS VILLAGE, NY 11428-1352
(718) 464-5225
(718) 740-8838
Mailing address
11 IRENE LN N, PLAINVIEW, NY 11803-1913
(718) 217-0500
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
213205
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02282511
—
NY
Enumeration date
09/20/2006
Last updated
04/26/2018
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