Provider Demographics
NPI:1639391600
Name:LOPEZ, EILEEN M (MA, OTR)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:M
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MA, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E 60TH ST
Mailing Address - Street 2:APT. D1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1437
Mailing Address - Country:US
Mailing Address - Phone:646-220-3149
Mailing Address - Fax:
Practice Address - Street 1:211 E 60TH ST
Practice Address - Street 2:APT. D1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1437
Practice Address - Country:US
Practice Address - Phone:646-220-3149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist