Lopez Crisostomo, Sofia Marie

Lopez Crisostomo, Sofia Marie is an individual health care provider with primary practice located at 4016 Raintree Rd Suite 240, Chesapeake VA 23321-3700. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Lopez Crisostomo, Sofia Marie can be contacted via phone (757) 488-2864.

Contact Information

Primary practice address
4016 Raintree Rd Suite 240 Chesapeake VA 23321-3700
Phone: (757) 488-2864
Fax: (757) 488-4735
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X 2305204168 Virginia

Profile Details

NPI number 1770892200
LBN Legal business name Lopez Crisostomo, Sofia Marie
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2010
Last updated Oct 1st, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770892200 NPPES
Virginia MEDICAID 004979061

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