Provider Demographics
NPI:1043860208
Name:LOPEZ-BURTON, NORMA RAE (N/A)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:RAE
Last Name:LOPEZ-BURTON
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CHAMBERS RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-3630
Mailing Address - Country:US
Mailing Address - Phone:530-902-5879
Mailing Address - Fax:
Practice Address - Street 1:22 CHAMBERS RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-3630
Practice Address - Country:US
Practice Address - Phone:530-902-5879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider