Provider Demographics
NPI:1679618664
Name:LOPES, JOANNE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:ELIZABETH
Last Name:LOPES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:1405 FOULK RD STE 101
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2769
Practice Address - Country:US
Practice Address - Phone:302-655-3242
Practice Address - Fax:302-655-5392
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0013477208D00000X, 208000000X
NJ25MA07728400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
077356 SK3Medicare PIN