Provider Demographics
NPI:1326656729
Name:LOPEZ-ALZATE, DANIELA (MLT)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:LOPEZ-ALZATE
Suffix:
Gender:F
Credentials:MLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 GRAND VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-1120
Mailing Address - Country:US
Mailing Address - Phone:857-241-7344
Mailing Address - Fax:
Practice Address - Street 1:129 BORDER ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-1903
Practice Address - Country:US
Practice Address - Phone:857-241-7344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory