Individual
JOSE R. LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD,FAAP
Contact information
Practice address
470 STILLWELLS CORNER RD, FREEHOLD, NJ 07728-2969
(732) 780-3333
(732) 780-6968
Mailing address
470 STILLWELLS CORNER RD, FREEHOLD, NJ 07728-2969
(732) 780-3333
(732) 780-6968
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA02343600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4685601
—
NJ
Enumeration date
07/27/2006
Last updated
07/08/2007
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