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NPI Code Detail

MEDICARE: JON RESTIVO

MEDICARE: JON RESTIVO
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1528991585
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON RESTIVO
Provider Business Mailing Address
First Line : 95 OLD SHORT HILLS RD
Second Line :
City : WEST ORANGE
State : NJ
Zip : 07052-1008
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 RIVER AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-5237
Country : US
Telephone Number : 848-480-9671
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ JON RESTIVO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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