Individual
ALEXANDER LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
(215) 456-9015
Mailing address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
(215) 456-9015
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MT219473
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT219473
PA
Other
Enumeration date
07/03/2019
Last updated
12/05/2023
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