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NPI Code Detail

MEDICARE: AMANDA L LOPEZ

MEDICARE: AMANDA L LOPEZ
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1548103153
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA L LOPEZ
Provider Business Mailing Address
First Line : 760 BROADWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-5317
Country : US
Telephone Number : 718-963-8000
Fax Number :
Provider Business Practice Location Address
First Line : 760 BROADWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-5317
Country : US
Telephone Number : 718-963-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2026
Last Update Date : 04/10/2026

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Directions to “ AMANDA L LOPEZ ” Practice Location

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