Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | RO24887-1 | NY |
NPI | 1013234095 |
---|---|
Provider Name | Mr. Frank John Lopes |
First Address | Lynbrook, NY 11563-2527 |
Second Address | Lynbrook, NY 11563-2527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2010 |
Last Update Date | 29/04/2010 |