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JEFFERSON GONZALO LOPEZ PA
NPI 1407619455
Physician Assistant in Central Islip, NY

Active since February 02, 2024
225 EASTVIEW DR, CENTRAL ISLIP, NY 11722(631) 665-1600 Get Directions Write a Review

NPPES record last updated: February 2, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jefferson Gonzalo Lopez Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFERSON GONZALO LOPEZ PA (NPI 1407619455) is an individual physician assistant in Central Islip, New York and active in the NPI registry since February 2024.

NPPES Registry Identity

NPI1407619455
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJEFFERSON GONZALO LOPEZCredential: PA
Location Address225 EASTVIEW DRCentral Islip, NY 11722-4539
Mailing Address225 Eastview DrCentral Islip, NY 11722-4539 · (631) 665-1600
Phone(631) 665-1600
Sole ProprietorYes
Enumeration DateFebruary 2, 2024
NPPES CertifiedFebruary 2, 2024
✔ NPI 1407619455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
225 EASTVIEW DR, Central Islip, NY 11722
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAUREN KELLY RADECKI PA-C
Physician Assistant
225 EASTVIEW DR
CENTRAL ISLIP, NY 11722
Suffolk County (631) 665-1600
JILLIAN COLCHAMIRO
Physician Assistant
225 EASTVIEW DR
CENTRAL ISLIP, NY 11722
Suffolk County (631) 665-1600
SHANNON KERRIANNE CAMUSO PA-C
Physician Assistant
225 EASTVIEW DR
CENTRAL ISLIP, NY 11722
Suffolk County (631) 665-1600
MIRIAM RAITPORT
Physician Assistant
225 EASTVIEW DR
CENTRAL ISLIP, NY 11722
Suffolk County (000) 000-0000
MARIA KURTH
Physician Assistant
225 EASTVIEW DR
CENTRAL ISLIP, NY 11722
Suffolk County (631) 665-1600
SANDY HU PA-C
Physician Assistant
225 EASTVIEW DR
CENTRAL ISLIP, NY 11722
Suffolk County (347) 335-3953
NICOLE BARRETT
Physician Assistant
225 EASTVIEW DR
CENTRAL ISLIP, NY 11722
Suffolk County (631) 665-1600
MRS. STEPHANIE FRISZ-GIOIA MS, CASACT
Counselor
225 EASTVIEW DR
CENTRAL ISLIP, NY 11722
Suffolk County (631) 913-8655

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jefferson Lopez's NPI number?

The NPI number for Jefferson Lopez is 1407619455. It was assigned to this individual provider in the NPPES registry on February 2, 2024.

Where is Jefferson Lopez located?

Jefferson Lopez practices at 225 Eastview Dr, Central Islip, NY 11722. The listed phone number is (631) 665-1600.

What is Jefferson Lopez's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Jefferson Lopez was last updated on February 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.