Provider Demographics
NPI:1003230285
Name:LOPEZ, CARINA LUNA (LAC)
Entity Type:Individual
Prefix:DR
First Name:CARINA
Middle Name:LUNA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 VAN CORTLANDT PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-4203
Mailing Address - Country:US
Mailing Address - Phone:917-701-8549
Mailing Address - Fax:
Practice Address - Street 1:541 VAN CORTLANDT PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-4203
Practice Address - Country:US
Practice Address - Phone:917-701-8549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-09
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005234171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist