Provider Demographics
NPI:1376068163
Name:PRESTIFILIPPO, ANGELA ROSE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:ROSE
Last Name:PRESTIFILIPPO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 ISLAND RD APT 33
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1137
Mailing Address - Country:US
Mailing Address - Phone:551-556-9161
Mailing Address - Fax:
Practice Address - Street 1:450 ISLAND RD APT 33
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1137
Practice Address - Country:US
Practice Address - Phone:551-556-9161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00363500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty