Provider Demographics
NPI:1275551004
Name:LOPEZ, PATRICIA M (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:BOX 3000
Mailing Address - Street 2:1 GUSTAVE L LEVY PLACE MOUNT SINAI DEPARTMENT OF MEDICI
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:212-731-5210
Practice Address - Street 1:5 EAST 98TH STREET
Practice Address - Street 2:MOUNT SINAI HOSPITAL LIVER DISEASE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-0034
Practice Address - Fax:212-289-7738
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY002223207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I20442Medicare UPIN
5142R2Medicare ID - Type Unspecified