MEDICARE: MRS. ADRIENNE LOPRESTI LMSW, R

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
1	1041C0700X	Clinical Social Worker	R058156	NY

General Provider Information

NPI Number	:	1780779645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ADRIENNE LOPRESTI LMSW, R

Provider Business Mailing Address
First Line	:	43 SAINT MARKS PL
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-7043
Country	:	US
Telephone Number	:	516-808-4605
Fax Number	:	516-799-3081

Provider Business Practice Location Address
First Line	:	75 GRAND AVE
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-4905
Country	:	US
Telephone Number	:	516-799-3203
Fax Number	:	516-799-3081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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