Provider Demographics
NPI:1235258880
Name:STOPA, LORETTA JEAN (FNP)
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:JEAN
Last Name:STOPA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 SPANKTOWN RD
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921-3114
Mailing Address - Country:US
Mailing Address - Phone:845-342-6060
Mailing Address - Fax:845-342-6040
Practice Address - Street 1:100 PHILLIPS HILL RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4134
Practice Address - Country:US
Practice Address - Phone:845-634-6752
Practice Address - Fax:845-634-9002
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331222-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner