Individual
DR. GREGORY M LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6288 WOODHAVEN BLVD, REGO PARK, NY 11374-3738
(718) 478-2000
(718) 478-2001
Mailing address
6288 WOODHAVEN BLVD, REGO PARK, NY 11374-3738
(718) 478-2000
(718) 478-2001
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV004048
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00713346
—
NY
Enumeration date
06/15/2006
Last updated
11/21/2012
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