Provider Demographics
NPI:1124375167
Name:LOPEZ-ALIAGA, MONICA P (MSED)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:P
Last Name:LOPEZ-ALIAGA
Suffix:
Gender:
Credentials:MSED
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:P
Other - Last Name:VILELA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3111 74TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1801
Mailing Address - Country:US
Mailing Address - Phone:646-285-7269
Mailing Address - Fax:
Practice Address - Street 1:3111 74TH ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1801
Practice Address - Country:US
Practice Address - Phone:646-285-7269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY174400000XOther17