Most Relevant Information
Provider Data
| NPI Number: | 1003375767 |
| Provider Name: | LUZ AMPARO LOPEZ LOPEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/13/2019 |
| Last Updated: | 03/13/2019 |
Provider Practice Location
11835 QUEENS BLVD FL 6
FOREST HILLS
NY
113757211
Practice Location Phone/Fax
| Phone: | 3479242281 |
| Fax: |
Provider Mailing Location
11835 QUEENS BLVD FL 6
FOREST HILLS
NY
113757211
Provider Mailing Phone/Fax
| Phone: | 3479242281 |
| Fax: |