Provider Demographics
NPI:1659546323
Name:RICHARD RESTIFO, MD PC
Entity Type:Organization
Organization Name:RICHARD RESTIFO, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:RESTIFO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-772-1444
Mailing Address - Street 1:200 S ORANGE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3349
Mailing Address - Country:US
Mailing Address - Phone:203-772-1444
Mailing Address - Fax:
Practice Address - Street 1:200 S ORANGE CENTER RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3349
Practice Address - Country:US
Practice Address - Phone:203-772-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT240000131Medicare PIN