Individual
ALISON LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-4079
Mailing address
600 82ND ST APT 1, NORTH BERGEN, NJ 07047-2432
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
017986
NY
363A00000X
Physician Assistant
25MP00349900
NJ
Other
Enumeration date
12/21/2014
Last updated
05/02/2019
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