Individual
ESTEBAN JESUS KOSAK LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5401 OLD YORK RD STE 363, PHILADELPHIA, PA 19141-3045
(215) 456-8520
Mailing address
5401 OLD YORK RD STE 363, PHILADELPHIA, PA 19141-3045
(215) 456-8520
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
MT231664
PA
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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