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NPI Code Detail

MEDICARE: SANDRA LETICIA LOPEZ COLLADO M.D.

MEDICARE: SANDRA LETICIA LOPEZ COLLADO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician289727NY

General Provider Information

NPI Number : 1922403526
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA LETICIA LOPEZ COLLADO M.D.
Provider Business Mailing Address
First Line : 515 W 207TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10034-2645
Country : US
Telephone Number : 212-544-7777
Fax Number :
Provider Business Practice Location Address
First Line : 234 E 149TH ST
Second Line :
City : BRONX
State : NY
Zip : 10451-5504
Country : US
Telephone Number : 646-787-7236
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2014
Last Update Date : 05/15/2026

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Directions to “ SANDRA LETICIA LOPEZ COLLADO M.D.” Practice Location

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