Healthcare Provider Details

I. General information

NPI: 1154259976
Provider Name (Legal Business Name): ANTONIA ELIZABETH LOPRESTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 METRO BLVD
NUTLEY NJ
07110-6102
US

IV. Provider business mailing address

774 WOODFIELD CT
RIDGEWOOD NJ
07450-1008
US

V. Phone/Fax

Practice location:
  • Phone: 201-637-7115
  • Fax:
Mailing address:
  • Phone: 201-783-5828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA06519500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: