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NPI Code Detail

MEDICARE: OTHONIEL LOPEZ MSW

MEDICARE: OTHONIEL LOPEZ MSW
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
11041C0700XClinical Social WorkerCSW006681GA

General Provider Information

NPI Number : 1295031771
Entity Type Code : Individual
Provider Name (Legal Business Name) : OTHONIEL LOPEZ MSW
Provider Business Mailing Address
First Line : 145 W 15TH ST FL 2
Second Line :
City : NEW YORK
State : NY
Zip : 10011-6701
Country : US
Telephone Number : 718-963-4430
Fax Number : 718-963-0814
Provider Business Practice Location Address
First Line : 217 HAVEMEYER ST
Second Line : 4TH FL
City : BROOKLYN
State : NY
Zip : 11211-6277
Country : US
Telephone Number : 718-963-4430
Fax Number : 718-963-0814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2011
Last Update Date : 12/19/2025

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Directions to “ OTHONIEL LOPEZ MSW” Practice Location

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