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General NPI Number Information
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NPI Number | 1275448425
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Entity Type | Individual
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Provider Name | JAIME RESTIVO
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Gender | Female
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 44 COURT ST STE 1217
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City | BROOKLYN
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State | NY
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Zip | 11201-4410
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Country | US
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Telephone | 347-479-1868
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Fax |
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Provider Business Mailing Address
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Address Line | 1063 BARBARA CT
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City | N BELLMORE
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State | NY
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Zip | 11710-1503
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Country | US
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Telephone | 516-528-6819
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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