Provider Demographics
NPI:1457899650
Name:LOPEZ, RAYMOND J (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:J
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 POST RD
Mailing Address - Street 2:STE D3
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-1615
Mailing Address - Country:US
Mailing Address - Phone:201-485-7518
Mailing Address - Fax:201-485-7517
Practice Address - Street 1:9 POST RD STE D3
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-1615
Practice Address - Country:US
Practice Address - Phone:201-485-7518
Practice Address - Fax:201-485-7517
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00740700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor