Provider Demographics
NPI:1750467072
Name:LOPRESTI, ROBERT WILLIAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:LOPRESTI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-0108
Mailing Address - Country:US
Mailing Address - Phone:732-842-4553
Mailing Address - Fax:732-530-7498
Practice Address - Street 1:569 RIVER RD
Practice Address - Street 2:SUITE 7
Practice Address - City:FAIR HAVEN
Practice Address - State:NJ
Practice Address - Zip Code:07704-3262
Practice Address - Country:US
Practice Address - Phone:732-842-4553
Practice Address - Fax:732-530-7498
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SIOO195700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ633836Medicare ID - Type Unspecified