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NPI Code Detail

MEDICARE: MARIANA NINO LOPEZ

MEDICARE: MARIANA NINO 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 : 1972445732
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANA NINO LOPEZ
Provider Business Mailing Address
First Line : 760 BROADWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-5317
Country : US
Telephone Number : 646-614-5318
Fax Number :
Provider Business Practice Location Address
First Line : 760 BROADWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-5317
Country : US
Telephone Number : 646-614-5318
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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Directions to “ MARIANA NINO LOPEZ ” Practice Location

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