Provider Demographics
NPI:1669030110
Name:LOPEZ, BRIANNA LYNN
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LYNN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 KNOLLWOOD ROAD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:399 KNOLLWOOD ROAD
Practice Address - Street 2:SUITE 108
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603
Practice Address - Country:US
Practice Address - Phone:914-949-8501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic