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NPI Code Detail

MEDICARE: WENDY LOPEZ RD

MEDICARE: WENDY LOPEZ RD
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
1133V00000XRegistered Dietitian86021832NY

General Provider Information

NPI Number : 1114323672
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY LOPEZ RD
Provider Business Mailing Address
First Line : 1005 E 174TH ST APT 10B
Second Line :
City : BRONX
State : NY
Zip : 10460-5211
Country : US
Telephone Number : 718-542-4084
Fax Number :
Provider Business Practice Location Address
First Line : 7600 CHEVY CHASE DR STE 300
Second Line :
City : AUSTIN
State : TX
Zip : 78752-1599
Country : US
Telephone Number : 415-651-4333
Fax Number : 844-572-0001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2014
Last Update Date : 08/21/2025

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