Individual
DR. MICHAEL J PRESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
169 LIBBEY INDUSTRIAL PKWY, 2ND FLOOR, WEYMOUTH, MA 02189-3101
(781) 682-1060
(781) 682-1061
Mailing address
169 LIBBEY INDUSTRIAL PKWY, 2ND FLOOR, WEYMOUTH, MA 02189-3101
(781) 682-1060
(781) 682-1061
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
4195
MA
103TH0100X
Health Service Psychologist
4195
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0503509
—
MA
01
—
1047128
CIGNA PROVIDER NUMBER
MD
01
—
461315000
MAGELLAN PROVIDER NUMBER
MD
01
—
6101022
EVERCARE PROVIDER NUMBER
MD
01
—
W06395
BCBS PROVIDER NUMBER
MD
Enumeration date
10/17/2006
Last updated
03/04/2010
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