Emmanuel Lopez
Individual provider Active NPI Driver · Elizabeth, NJ
NPI 1710366117 · NPPES record last updated May 19, 2015
Key facts
- NPI
- 1710366117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- MIRA00383 (NJ)
- Practice address
- 520 Westfield Ave
Elizabeth, NJ 07208-1658 - Phone
- (908) 662-1717
- Fax
- (908) 662-1718
- NPI assigned
- May 19, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MIRA00383 | NJ | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Honest Medical Transportation | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | MIRA00383 | NJ | Yes |
Addresses
Primary practice location
520 Westfield Ave
Elizabeth, NJ 07208-1658
Mailing address
520 Westfield Ave
Elizabeth, NJ 07208-1658
Phone (908) 662-1717
Other providers in Elizabeth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.