Healthcare Provider Details

I. General information

NPI: 1649256280
Provider Name (Legal Business Name): NURIA LOPEZ-PAJARES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 W HUNTING PARK AVE SUITE 300-A
PHILADELPHIA PA
19140-2717
US

IV. Provider business mailing address

PO BOX 820933
PHILADELPHIA PA
19182-0933
US

V. Phone/Fax

Practice location:
  • Phone: 215-324-0600
  • Fax: 215-324-2795
Mailing address:
  • Phone: 215-324-0600
  • Fax: 215-324-2796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberMD 069596L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: