Doctor Name: | MR. PETER LOPEZ |
NPI Number: | 1346383197 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 44SC04634900 |
Business Practice Address: | 130 Powerville Rd Boonton, NJ - 070058705 |
Business Phone Number: | 9732995456 |
Business Fax Number: | |
Mailing Address: | 130 Powerville Rd, BOONTON |
State: | NJ |
Postal Code: | 070058705 |
Phone Number: | 9732995456 |
Fax Number: | |
NPI Enumeration Date: | 02/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 44SC04634900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |