Provider Demographics
NPI:1861435638
Name:LOPRESTI, THOMAS J (OD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:LOPRESTI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 FOREST AVENUE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-262-5070
Mailing Address - Fax:206-262-5333
Practice Address - Street 1:523 FOREST AVENUE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-262-5070
Practice Address - Fax:201-262-5333
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA5203152W00000X
NJ27OA00520300152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LO781448Medicare ID - Type Unspecified
NJU56918Medicare UPIN