Provider Demographics
NPI:1750779450
Name:LOPEZ DEL BOSQUE, YILLIAM (NP-C)
Entity type:Individual
Prefix:
First Name:YILLIAM
Middle Name:
Last Name:LOPEZ DEL BOSQUE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:YILLIAM
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:6803 BOULEVARD EAST APT 35
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-4510
Mailing Address - Country:US
Mailing Address - Phone:551-655-8891
Mailing Address - Fax:
Practice Address - Street 1:6803 BOULEVARD EAST APT 35
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:NJ
Practice Address - Zip Code:07093-4510
Practice Address - Country:US
Practice Address - Phone:551-655-8891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-03
Last Update Date:2015-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJA0714002363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health