Individual
JOHN RICHARD RESTIVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 N JAMES ST, ROME, NY 13440-2844
(315) 338-7029
Mailing address
185 GENESEE ST, SUITE 600, UTICA, NY 13501-2199
(315) 793-8806
(315) 793-8046
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
207464
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01647929
—
NY
05
—
01754118
—
NY
01
—
040426013913
FIDELIS
NY
01
—
10045243
CDPHP
NY
01
—
207464-9
WC
NY
01
—
300080976
RAIL ROAD MEDICARE
NY
01
—
4196774
GHI
NY
01
—
958476
MVP
NY
01
—
P010207464
BCBS
NY
Enumeration date
05/04/2006
Last updated
05/01/2023
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