Provider Demographics
NPI:1811994007
Name:LOPREIATO, MATTEO JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:MATTEO
Middle Name:JOSEPH
Last Name:LOPREIATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 WORTHINGTON RDG
Mailing Address - Street 2:SUITE A
Mailing Address - City:BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06037-3233
Mailing Address - Country:US
Mailing Address - Phone:860-829-7337
Mailing Address - Fax:
Practice Address - Street 1:742 WORTHINGTON RDG
Practice Address - Street 2:SUITE A
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-3233
Practice Address - Country:US
Practice Address - Phone:860-829-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041963208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001419630Medicaid