Provider Demographics
NPI:1568042661
Name:RESTREPO, ROSA E
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:E
Last Name:RESTREPO
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 1:547 W 180TH ST APT 30A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-5852
Mailing Address - Country:US
Mailing Address - Phone:347-954-6001
Mailing Address - Fax:
Practice Address - Street 1:547 W 180TH ST APT 30A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-5852
Practice Address - Country:US
Practice Address - Phone:347-954-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty