Individual provider · Type 1 NPI

Jacqueline Marie Lopez, RPA-C

Surgical Physician Assistant · Bay Shore, NY

NPI number 1477828952 Active

Practice location

301 E Main St
Bay Shore, NY 11706-8408

Call (516) 521-3744 Map

Mailing address

3 Clover Ln
Kings Park, NY 11754-3914

Other practice locations

  • 259 1st St, Mineola, NY 11501-3957 · (516) 663-0333

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400XNone listed
Surgical Physician Assistant Primary 363AS0400X23015496 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1477828952

Jacqueline Marie Lopez, RPA-C's National Provider Identifier is 1477828952, issued on Mar 15, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Bay Shore, NY. The record was last updated on Jun 13, 2019.