Individual
JENNIFER LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 S HILLSIDE AVE, ELMSFORD, NY 10523-3602
(914) 409-3588
Mailing address
25 S HILLSIDE AVE, ELMSFORD, NY 10523-3602
(914) 409-3588
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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