Individual
LEONARDO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
965 BROADHOLLOW RD, FARMINGDALE, NY 11735-3906
(631) 694-3520
(631) 694-3569
Mailing address
965 BROADHOLLOW RD, FARMINGDALE, NY 11735-3906
(631) 694-3520
(631) 694-3569
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
9452
NY
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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