Healthcare Provider Details

I. General information

NPI: 1962625640
Provider Name (Legal Business Name): PATRICIA LOPRESTI RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 MAIN ST SUITE 400
SOUTH WEYMOUTH MA
02190-1868
US

IV. Provider business mailing address

77 ACCORD PARK DR BLDG D4 - CREDENTIALING
NORWELL MA
02061
US

V. Phone/Fax

Practice location:
  • Phone: 781-331-7799
  • Fax:
Mailing address:
  • Phone: 781-952-1526
  • Fax: 781-878-8627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2121
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: