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General NPI Number Information
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NPI Number | 1780405506
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Entity Type | Individual
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Provider Name | EMANUEL LOPEZ APN
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Gender | Male
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 246 CLIFTON AVE STE 4
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City | CLIFTON
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State | NJ
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Zip | 07011-1953
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Country | US
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Telephone | 973-928-2715
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Fax | 201-205-2433
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Provider Business Mailing Address
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Address Line | 64 GLENWOOD AVE
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City | LAKE HIAWATHA
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State | NJ
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Zip | 07034-1012
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Country | US
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Telephone | 201-247-3223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ15151400
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License Number State | NJ
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