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1538568894
IVY GRACE LOPEZ
JAMAICA, NY
NPI
1538568894
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: NY 018985)
Enumeration Date
2014-08-22
Last Update Date
2014-08-22
Business Address
Mrs. IVY GRACE LOPEZ OTR/L
8829 180TH ST FL 2
JAMAICA, NY 11432-4737
Phone number: 914-426-9779
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Mailing Address
Mrs. IVY GRACE LOPEZ OTR/L
8829 180TH ST FL 2
JAMAICA, NY 11432-4737
Phone number: 914-426-9779
Copy
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