Individual
EMMANUEL OCTAVIO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
31 HERITAGE DR APT B, NEW CITY, NY 10956-5304
(917) 324-0079
Mailing address
31 HERITAGE DR APT B, NEW CITY, NY 10956-5304
(917) 324-0079
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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