Riestra, Juan L.

Riestra, Juan L. is an sole proprietor health care provider with primary practice located at 70 Park St , Montclair NJ 07042-5907. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Psychiatry, which is considered as his primary health care specialty. Riestra, Juan L. can be contacted via phone (973) 655-9300.

Contact Information

Primary practice address
70 Park St Montclair NJ 07042-5907
Phone: (973) 655-9300
Fax: (973) 439-5780
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X 25MA05785800 New Jersey

Profile Details

NPI number 1841255320
LBN Legal business name Riestra, Juan L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 19th, 2006
Last updated Aug 30th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841255320 NPPES
New Jersey MEDICAID 7886802

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