Active NPI
Marlon Lopez
- Physical Therapy Assistant
- New Hyde Park, NY
National Provider Identifier
1811864150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 014580
- Practice address
- 7649 Hewlett St
New Hyde Park, NY 11040-1429 - Phone
- (212) 388-0767
- Fax
- (212) 388-0767
- NPI assigned
- Oct 21, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 014580 | NY | Primary |
Addresses
Primary practice location
7649 Hewlett St
New Hyde Park, NY 11040-1429
Mailing address
6618 53Rd Rd
Maspeth, NY 11378-1708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761004800000",
"number": "1811864150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6618 53RD RD",
"city": "MASPETH",
"state": "NY",
"postal_code": "113781708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7649 HEWLETT ST",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110401429",
"telephone_number": "212-388-0767",
"fax_number": "212-388-0767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MARLON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-21",
"last_updated": "2025-10-21",
"certification_date": "2025-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "014580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.