Organization
GREAT LAKES NP OF PSYCHIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORRAINE A. LOPEZ PMHNP (OWNER)
(716) 908-1711
Entity
Organization
Contact information
Practice address
3802 SENECA ST, WEST SENECA, NY 14224-3433
(716) 677-5418
Mailing address
PO BOX 61, EAST AMHERST, NY 14051-0061
(716) 908-1711
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400896
NY
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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