Provider Demographics
NPI:1982857082
Name:PRESTI, SALVATORE J (PHD)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:J
Last Name:PRESTI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1409 LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1656
Mailing Address - Country:US
Mailing Address - Phone:215-875-2187
Mailing Address - Fax:215-545-0828
Practice Address - Street 1:1417 W OREGON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4926
Practice Address - Country:US
Practice Address - Phone:215-334-1311
Practice Address - Fax:215-334-4512
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004715L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist