JEFFERSON GONZALO LOPEZ

CENTRAL ISLIP, NY
NPI1407619455
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2024-02-02
Last Update Date2024-02-02
Business Address
JEFFERSON GONZALO LOPEZ PA
225 EASTVIEW DR
CENTRAL ISLIP, NY 11722-4539
Phone number: 631-665-1600
Mailing Address
JEFFERSON GONZALO LOPEZ PA
225 EASTVIEW DR
CENTRAL ISLIP, NY 11722-4539
Phone number: 631-665-1600
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