Individual
GIOVANNI LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP, BC, LAC.
Contact information
Practice address
2025 BRENTWOOD RD, BRENTWOOD, NY 11717
(631) 234-4949
(631) 234-3307
Mailing address
2025 BRENTWOOD RD, BRENTWOOD, NY 11717-4656
(631) 234-4949
(631) 234-3307
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
342801
NY
Other
Enumeration date
04/23/2007
Last updated
08/20/2021
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