Lopez Plaza, Ileana

Lopez Plaza, Ileana is an individual health care provider with primary practice located at 750 Washington St #826 , Boston MA 02111. She recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, which is considered as her primary health care specialty. Lopez Plaza, Ileana can be contacted via phone (617) 636-5842.

Contact Information

Primary practice address
750 Washington St #826 Boston MA 02111
Fax: (617) 636-3175
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine 207ZP0105X 221290 Massachusetts

Profile Details

NPI number 1396727715
LBN Legal business name Lopez Plaza, Ileana
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2005
Last updated Jul 31st, 2007 - about 17 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 1396727715 NPPES
Massachusetts MEDICAID 2075431
Massachusetts Other A37261

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