Provider Demographics
NPI:1215960232
Name:LIGRESTI, LOUISE G (MD)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:G
Last Name:LIGRESTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VALLEY HEALTH PLZ
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3628
Mailing Address - Country:US
Mailing Address - Phone:201-634-5353
Mailing Address - Fax:201-634-5343
Practice Address - Street 1:1 VALLEY HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3628
Practice Address - Country:US
Practice Address - Phone:201-634-5353
Practice Address - Fax:201-634-5343
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06569700207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7294701Medicaid
NJ830004825OtherRAILROAD MEDICARE
NJ830004825OtherRAILROAD MEDICARE
NJ7294701Medicaid