Provider Demographics
NPI:1265586184
Name:RESTAINO, RAYMOND PETER
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:PETER
Last Name:RESTAINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RAYMOND
Other - Middle Name:PETER
Other - Last Name:RESTAINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:1062 S HILL RD
Mailing Address - Street 2:
Mailing Address - City:GRAHAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12740-5019
Mailing Address - Country:US
Mailing Address - Phone:845-647-4259
Mailing Address - Fax:845-292-4206
Practice Address - Street 1:1062 S HILL RD
Practice Address - Street 2:
Practice Address - City:GRAHAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12740-5019
Practice Address - Country:US
Practice Address - Phone:845-647-4259
Practice Address - Fax:845-292-4206
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0305141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY186114OtherPIN NUMBER
NY455262OtherPIN NUMBER
NY186114OtherPIN NUMBER