| Doctor Name: | JOSEPH STANLEY RESTIVO |
| NPI Number: | 1992905814 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | |
| Business Practice Address: | 4700 Las Vegas Blvd N Attn: Credentials Office Nellis Afb, NV - 891916600 |
| Business Phone Number: | 7026533067 |
| Business Fax Number: | 7026533398 |
| Mailing Address: | 4700 Las Vegas Blvd N, Attn: Credentials Office NELLIS AFB |
| State: | NV |
| Postal Code: | 891916600 |
| Phone Number: | 7026533067 |
| Fax Number: | 7026533398 |
| NPI Enumeration Date: | 07/19/2007 |
| NPI Last Update Date: | 12/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |