Individual
MARILYN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
46 TODD RD, VALLEY STREAM, NY 11580-4018
(516) 823-0274
Mailing address
46 TODD RD, VALLEY STREAM, NY 11580-4018
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
F340345
NY
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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