Healthcare Provider Details

I. General information

NPI: 1962828277
Provider Name (Legal Business Name): NEW JERSEY MEDICAL SERVICES GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2014
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 HANOVER RD STE 230
FLORHAM PARK NJ
07932-1508
US

IV. Provider business mailing address

7125 ORCHARD LAKE RD STE 120
WEST BLOOMFIELD MI
48322-3627
US

V. Phone/Fax

Practice location:
  • Phone: 866-630-2308
  • Fax:
Mailing address:
  • Phone: 866-607-2308
  • Fax: 248-855-5455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: PHILIP JOHN LOPRESTI
Title or Position: OWNER/DO
Credential: DO
Phone: 516-726-0336