Provider Demographics
NPI:1982655585
Name:RESTO, MIGDALIA (MD)
Entity Type:Individual
Prefix:
First Name:MIGDALIA
Middle Name:
Last Name:RESTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1754
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-1754
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:CEDAR CREST & I-78
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18105-1556
Practice Address - Country:US
Practice Address - Phone:610-402-7632
Practice Address - Fax:610-402-7600
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056942L2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001541856Medicaid
PAG10530Medicare UPIN
PA001541856Medicaid