Individual
ANDREW LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11082 KNIGHTS RD, PHILADELPHIA, PA 19154-3511
(215) 632-9040
(215) 632-0610
Mailing address
11082 KNIGHTS RD, PHILADELPHIA, PA 19154-3511
(215) 632-9040
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD417634
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101880942-0001
—
PA
Enumeration date
01/18/2007
Last updated
02/14/2012
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