Doctor Name: | KATY CECILIA LOPEZ VASQUEZ |
NPI Number: | 1174833370 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 57-018398 |
Business Practice Address: | 1 Green Hills Dr Verona, VA - 244822654 |
Business Phone Number: | 5402484487 |
Business Fax Number: | 5402485312 |
Mailing Address: | Po Box 388, FISHERSVILLE |
State: | VA |
Postal Code: | 229390388 |
Phone Number: | 5409325168 |
Fax Number: | 5409325875 |
NPI Enumeration Date: | 10/21/2010 |
NPI Last Update Date: | 08/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 57-018398 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |