Provider Demographics
NPI:1649256280
Name:LOPEZ-PAJARES, NURIA (MD)
Entity type:Individual
Prefix:
First Name:NURIA
Middle Name:
Last Name:LOPEZ-PAJARES
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 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-324-0600
Mailing Address - Fax:215-324-2796
Practice Address - Street 1:133 W HUNTING PARK AVE
Practice Address - Street 2:SUITE 300-A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-2717
Practice Address - Country:US
Practice Address - Phone:215-324-0600
Practice Address - Fax:215-324-2795
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 069596L2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001793782Medicaid
PA10510OtherBRAVO HEALTH
PA519081OtherCOVENTRY HEALTH AMERICA
PA7520213OtherAETNA PPO
PA0122020000OtherINDEPENDENCE BLUE CROSS
PA110209714OtherRAILROAD MEDICARE
PA479554OtherHIGHMARK BLUE SHIELD
PA3046233OtherAETNA HMO
PA1148067OtherKEYSTONE MERCY HEALTH
PA3046233OtherAETNA HMO
PA001793782Medicaid