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NPI Code Detail

MEDICARE: DR. PHILIP JOHN LOPRESTI DO

MEDICARE: DR. PHILIP JOHN LOPRESTI DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician194532NY

General Provider Information

NPI Number : 1417047648
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILIP JOHN LOPRESTI DO
Provider Business Mailing Address
First Line : 6860 AUSTIN ST
Second Line : STE 400
City : FOREST HILLS
State : NY
Zip : 11375-4245
Country : US
Telephone Number : 248-855-5355
Fax Number :
Provider Business Practice Location Address
First Line : 10810 72ND AVE
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-5338
Country : US
Telephone Number : 718-261-1471
Fax Number : 718-261-2402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2006
Last Update Date : 10/28/2019

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