Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 107545 | NY |
NPI | 1003576323 |
---|---|
Provider Name | Mrs. Erika Lopez |
First Address | Central Islip, NY 11722-1212 |
Second Address | Mount Sinai, NY 11766-2026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2021 |
Last Update Date | 29/12/2021 |