Provider Demographics
NPI:1932069812
Name:LOPEZ, NAYELIS ESTIVALIS
Entity type:Individual
Prefix:
First Name:NAYELIS
Middle Name:ESTIVALIS
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 BRYANT AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10474-6038
Mailing Address - Country:US
Mailing Address - Phone:347-205-0473
Mailing Address - Fax:
Practice Address - Street 1:735 BRYANT AVE APT 2A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10474-6038
Practice Address - Country:US
Practice Address - Phone:347-205-0473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor