MEDICARE: ANNIE LOPES

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
1	374U00000X	Home Health Aide	HP0180000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1235554262	OTHER	NJ	NPI

General Provider Information

NPI Number	:	1043625387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIE LOPES

Provider Business Mailing Address
First Line	:	505 HIGH ST
Second Line	:
City	:	BURLINGTON
State	:	NJ
Zip	:	08016-4503
Country	:	US
Telephone Number	:	609-614-2948
Fax Number	:	609-614-7801

Provider Business Practice Location Address
First Line	:	505 HIGH ST
Second Line	:
City	:	BURLINGTON
State	:	NJ
Zip	:	08016-4503
Country	:	US
Telephone Number	:	609-614-2948
Fax Number	:	609-614-7801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2014
Last Update Date	:	06/25/2014

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Directions to “ ANNIE LOPES ” Practice Location

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