Individual
GUILLERMO RIESTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 WILLIAMSON ST, ELIZABETH, NJ 07202-3674
(908) 994-5480
Mailing address
240 WILLIAMSON ST STE 200, ELIZABETH, NJ 07202-3671
(908) 353-1777
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00381700
NJ
Other
Enumeration date
05/08/2022
Last updated
09/02/2024
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