Individual
GENESIS NICOLE AYALA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
725 ALBANY ST FL 8, BOSTON, MA 02118-3549
(617) 414-4841
Mailing address
801 ALBANY ST, BOSTON, MA 02119-2560
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
022419
PR
208000000X
Pediatrics Physician
35141
PR
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
3014767
MA
Other
Enumeration date
07/12/2019
Last updated
09/13/2023
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