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NPI Code Detail

MEDICARE: MISS REBECCA ALMA-ROSA LOPEZ RN

MEDICARE: MISS REBECCA ALMA-ROSA 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 Nurse721817NY

General Provider Information

NPI Number : 1962958942
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS REBECCA ALMA-ROSA LOPEZ RN
Provider Business Mailing Address
First Line : 3448 107TH ST FL 2
Second Line :
City : CORONA
State : NY
Zip : 11368-1226
Country : US
Telephone Number : 347-724-4976
Fax Number :
Provider Business Practice Location Address
First Line : 6135 JUNCTION BLVD
Second Line :
City : REGO PARK
State : NY
Zip : 11374-2771
Country : US
Telephone Number : 718-271-1565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2016
Last Update Date : 08/30/2016

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