Provider Demographics
NPI:1780836502
Name:LOPEZ, RAMON (OTL)
Entity Type:Individual
Prefix:MR
First Name:RAMON
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 COBALT CROSS RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-1716
Mailing Address - Country:US
Mailing Address - Phone:215-949-9745
Mailing Address - Fax:
Practice Address - Street 1:1480 OXFORD VALLEY RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5630
Practice Address - Country:US
Practice Address - Phone:215-321-3921
Practice Address - Fax:215-321-9257
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008288225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist