Individual
JAKE ROLDAN RESTIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2300 I ST NW, WASHINGTON, DC 20052-0011
(202) 994-2987
Mailing address
1561 DIVISION ST, WEST CHARLTON, NY 12010-6810
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/04/2025
Last updated
08/19/2025
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