Provider Demographics
NPI:1629454467
Name:LOPEZ LOYO, PERSIO DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:PERSIO
Middle Name:DAVID
Last Name:LOPEZ LOYO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 3RD AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8114
Mailing Address - Country:US
Mailing Address - Phone:212-319-3977
Mailing Address - Fax:212-721-0806
Practice Address - Street 1:385 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6740
Practice Address - Country:US
Practice Address - Phone:212-319-3977
Practice Address - Fax:212-721-0806
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY294648207R00000X, 207RC0000X, 208M00000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist