Lopez, Jefferson Gonzalo
Lopez, Jefferson Gonzalo is an sole proprietor health care provider with primary practice located at 225 Eastview Dr , Central Islip NY 11722-4539. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Lopez, Jefferson Gonzalo can be contacted via phone (631) 665-1600.Contact Information
Primary practice address
225 Eastview Dr
Central Islip NY 11722-4539
Phone: (631) 665-1600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X |
Profile Details
| NPI number | 1407619455 |
|---|---|
| LBN Legal business name | Lopez, Jefferson Gonzalo |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 2nd, 2024 |
| Last updated | Feb 2nd, 2024 - about 9 months 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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