MEDICARE: DR. JOSEPH MICHAEL RESTIVO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	35084417R	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710982251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MICHAEL RESTIVO MD

Provider Business Mailing Address
First Line	:	1900 23RD ST
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-1404
Country	:	US
Telephone Number	:	330-971-7863
Fax Number	:	330-971-7860

Provider Business Practice Location Address
First Line	:	1900 23RD ST
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-1404
Country	:	US
Telephone Number	:	330-971-7863
Fax Number	:	330-971-7860

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	02/13/2014

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