Individual provider Active NPI

Christopher Restivo, CCC-SLP

  • Speech-Language Pathologist
  • Staten Island, NY
National Provider Identifier
1336517473
Registry record updated Sep 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
010554 Issued in NY
Practice address
356 Sprague Ave
Staten Island, NY 10307-1927
Phone
(917) 757-4286
NPI assigned
Sep 6, 2015
Last updated
Sep 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 010554 NY Primary

Addresses

Primary practice location

356 Sprague Ave
Staten Island, NY 10307-1927

Mailing address

356 Sprague Ave
Staten Island, NY 10307-1927
Phone (917) 757-4286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
010554NYMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441497600000",
    "number": "1336517473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 SPRAGUE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103071927",
            "telephone_number": "917-757-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 SPRAGUE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103071927",
            "telephone_number": "917-757-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESTIVO",
        "first_name": "CHRISTOPHER",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-06",
        "last_updated": "2015-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "010554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.