Basic Information
| Provider Information | |||||||||
| NPI: | 1619928462 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOPRESTI | ||||||||
| FirstName: | LEIGH | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 30 | ||||||||
| Address2: | |||||||||
| City: | GREAT BARRINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135289311 | ||||||||
| FaxNumber: | 4136440274 | ||||||||
| Practice Location | |||||||||
| Address1: | 71 HOSPITAL AVENUE | ||||||||
| Address2: | |||||||||
| City: | NORTH ADAMS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4136644088 | ||||||||
| FaxNumber: | 4136636405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 04/05/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 47265 | WI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 56005 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 0420007260 | VT | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0005973 | 05 | VT | MEDICAID | 039906261I | 01 | HUMANA | OTHER |