Healthcare Provider Details

I. General information

NPI: 1356275473
Provider Name (Legal Business Name): ANA LOPES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 EAST ST
NEW HAVEN CT
06511-5018
US

IV. Provider business mailing address

20 JOANNE DR
MILFORD CT
06460-5812
US

V. Phone/Fax

Practice location:
  • Phone: 203-495-7710
  • Fax:
Mailing address:
  • Phone: 203-495-7710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number34261
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: