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Contact Information

JUSTEN J LOPEZ, ATC, LAT, PES, GTS
10 GLENVILLE ST
GREENWICH, CT06831-3680
 Phone: 518-258-9828
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
 

Specialist/Technologist, Other

246Z00000X
Indicates primary specialty

NPI Profile & details for JUSTEN J LOPEZ · (Male)

NPI # 1356695944
Status Active
Credentials ATC, LAT, PES, GTS
Entity Individual
Enumeration date 11/03/2012
Last updated 02/16/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 1602
  • FL License # AL 3159
  • NY License # 002612
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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