Healthcare Provider Details

I. General information

NPI: 1558323303
Provider Name (Legal Business Name): ROSALIE A LOPRESTO DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BORTHWICK AVE STE 211
PORTSMOUTH NH
03801-7112
US

IV. Provider business mailing address

1 PARK AVE SUITE 2G
HAMPTON NH
03842-2113
US

V. Phone/Fax

Practice location:
  • Phone: 603-766-2600
  • Fax: 603-766-2625
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0285
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: