Individual
MS. ALEXA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 HARMAN ST, RIDGEWOOD, NY 11385-1612
(347) 564-1191
Mailing address
1717 HARMAN ST APT 3L, RIDGEWOOD, NY 11385-1612
(347) 564-1191
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
761115
NY
Other
Enumeration date
01/23/2022
Last updated
01/23/2022
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