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NPI Code Detail

MEDICARE: MISS VICTORIA LOPES

MEDICARE: MISS VICTORIA 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
12255A2300XAthletic TrainerL65307677457942NJ

General Provider Information

NPI Number : 1558759977
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS VICTORIA LOPES
Provider Business Mailing Address
First Line : 2569 JULIAT PL
Second Line :
City : UNION
State : NJ
Zip : 07083-3928
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 POMPTON RD
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2103
Country : US
Telephone Number : 973-720-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2015
Last Update Date : 01/07/2015

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Directions to “ MISS VICTORIA LOPES ” Practice Location

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