Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 157785 | NY |
NPI | 1134281975 |
---|---|
Provider Name | Dr. Sonia J. Lopez |
First Address | Jamaica, NY 11435-3610 |
Second Address | Jamaica, NY 11435-2642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 05/04/2017 |