Provider Demographics
NPI:1831477785
Name:LOPEZ, MARIA MARGARITA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA MARGARITA
Middle Name:
Last Name:LOPEZ
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 1:110 MANHATTAN AVE
Mailing Address - Street 2:#2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-8820
Mailing Address - Country:US
Mailing Address - Phone:860-796-8751
Mailing Address - Fax:
Practice Address - Street 1:381 PARK AVE S
Practice Address - Street 2:SUITE 428
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8806
Practice Address - Country:US
Practice Address - Phone:212-679-4000
Practice Address - Fax:212-679-4004
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282229208100000X
NJ25MA09792700208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation