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NPI Code Detail

MEDICARE: MRS. CHRISTINA LOPEZ RN

MEDICARE: MRS. CHRISTINA LOPEZ RN
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
1163W00000XRegistered Nurse603931NY

General Provider Information

NPI Number : 1053835504
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINA LOPEZ RN
Provider Business Mailing Address
First Line : 217 FOX CROFT VLG
Second Line :
City : LOCH SHELDRAKE
State : NY
Zip : 12759-5411
Country : US
Telephone Number : 845-428-2788
Fax Number :
Provider Business Practice Location Address
First Line : 217 FOX CROFT VLG
Second Line :
City : LOCH SHELDRAKE
State : NY
Zip : 12759-5411
Country : US
Telephone Number : 845-428-2788
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2017
Last Update Date : 07/26/2017

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