Provider Demographics
NPI:1144759671
Name:RESTITUYO, ESMERIZA
Entity Type:Individual
Prefix:
First Name:ESMERIZA
Middle Name:
Last Name:RESTITUYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31-65 138TH STREET
Mailing Address - Street 2:#F1
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:347-229-2938
Mailing Address - Fax:
Practice Address - Street 1:3165 138TH ST APT 1F
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2636
Practice Address - Country:US
Practice Address - Phone:347-229-2938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency