JUAN L. RIESTRA (NPI# 1841255320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841255320 |
| Entity Type | Individual |
| Full Name | JUAN L. RIESTRA |
| Credential | M.D. |
| Practice Address |
70 Park St Montclair NJ 07042-5907 |
| Mailing Address |
1 Rubino Rd West Caldwell NJ 07006-8033 |
| Practice Telephone | 9736559300 |
| Practice Fax Number | 9734395780 |
| Mailing Telephone | 9739851698 |
| Mailing Fax Number | 9734395780 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2010-08-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
25MA05785800 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 7886802 | 05 |
| Street Address |
70 PARK ST |
| City | MONTCLAIR |
| State | NJ |
| Zip Code | 07042-5907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982601845 | Peter J. Haigney | Chiropractor | 70 Park St, Montclair, NJ 07042-5907 | 2005-07-06 |
| 1629500012 | Bijal Patel LLC | Marriage & Family Therapist | 70 Park St, Suite 104, Montclair, NJ 07042-5907 | 2017-04-03 |
| 1417494113 | Tierney Farry | Counselor | 70 Park St, Suite 104, Montclair, NJ 07042-5907 | 2017-01-19 |
| 1992182372 | Jacqueline A Rondeau Psyd | Psychologist | 70 Park St, Suite 207, Montclair, NJ 07042-5907 | 2015-05-05 |
| 1508272782 | Bijal Patel | Marriage & Family Therapist | 70 Park St, Suite 104, Montclair, NJ 07042-5907 | 2014-07-08 |
| 1760806848 | Rebecca Suzanne Gillespie | Marriage & Family Therapist | 70 Park St, Suite 104, Montclair, NJ 07042-5907 | 2014-02-11 |
| 1932452919 | Sasha Acupuncture and Herbal Medicine LLC | Acupuncturist | 70 Park St, Montclair, NJ 07042-5907 | 2012-10-16 |
| 1073881223 | Patricia Safian | Acupuncturist | 70 Park St, Suite 208, Montclair, NJ 07042-5907 | 2011-12-02 |
| 1134366636 | P.haigney,l. Ac. | Acupuncturist | 70 Park St, Montclair, NJ 07042-5907 | 2009-01-21 |
| 1679733133 | Nicholas Kodjak | Acupuncturist | 70 Park St, Montclair, NJ 07042-5907 | 2008-06-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003451261 | Montclair Art Museum | Voluntary or Charitable | 3 South Mountain Avenue, Montclair, NJ 07042 | 2019-11-12 |
| 1740847797 | Magnify In-home Eyecare | Optometrist | Little Nursing Home, 71 Christopher Street, Montclair, NJ 07042 | 2019-05-24 |
| 1326539073 | Wendy C Kaplan | Social Worker | 460 Bloomfield Ave Suite 209, Montclair, NJ 07042 | 2018-05-29 |
| 1538666342 | Mary Elizabeth Mcgaughan | Psychologist | 239 Grove Street, Montclair, NJ 07042 | 2018-04-09 |
| 1023546777 | Alexander Scott Fisher | Dentist | 39 S Fullerton Ave Fl 2, Montclair, NJ 07042 | 2017-05-25 |
| 1942754825 | Kaity Rodriguez | Social Worker | 105 Grove St., Montclair, NJ 07042 | 2016-08-09 |
| 1144678889 | Melissa Cardinal | Nurse Practitioner | 36 Valley Road, 529, Montclair, NJ 07042 | 2016-06-02 |
| 1528413655 | Bellapianta Orthopaedics and Sports Medicine LLC | Orthopaedic Surgery | 1 Bay Avenue, Harries Pavilion, Suite 1, Montclair, NJ 07042 | 2016-04-26 |
| 1740647643 | Wendalyn Leona Browne | Massage Therapist | 37 Watchung Plaza, 2l, Montclair, NJ 07042 | 2016-01-22 |
| 1891168670 | Patience Moore | Social Worker | 460 Bloomfield Ave Ste 306, Montclair, NJ 07042 | 2015-11-03 |
| Find all providers in zip 07042 | ||||
| Taxonomy Code | 2084P0805X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Geriatric Psychiatry |
| Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699298687 | Nj Tms Institute LLC | Psychiatry & Neurology | 575 Route 28 Ste 2108, Raritan, NJ 08869-1354 | 2017-07-21 |
| 1063811156 | Bergen Geri-psych Institute | Psychiatry & Neurology | 20 Julia Ct, Township of Washington, NJ 07676-5108 | 2014-08-14 |
| 1679914386 | Christ L Zois | Psychiatry & Neurology | 712 Morven Ter, Sea Girt, NJ 08750-3205 | 2013-07-10 |
| 1922377258 | Pooja Tandon | Psychiatry & Neurology | 20 Hospital Dr Ste 12, Toms River, NJ 08755-6434 | 2011-12-15 |
| 1083946966 | Martin Freimer M.d., PC | Psychiatry & Neurology | 254b Mountain Avenue, Suite 306, Hackettstown, NJ 07840 | 2010-02-03 |
| 1083872154 | Hanny S Mabrouk | Psychiatry & Neurology | 671 Hoes Ln W Rm C-205, Piscataway, NJ 08854-8021 | 2008-05-27 |
| 1881882082 | David R. Mccomb, Do, LLC | Psychiatry & Neurology | 239 Taunton Blvd, A-2, Medford, NJ 08055-3471 | 2007-10-12 |
| 1679623797 | Steven Samuels | Psychiatry & Neurology | 350 Engle Street, 4 East, C/o Dept of Psychiatry, Englewood Hosp & Medical Ctr, Englewood, NJ 07631 | 2007-01-11 |
| 1912079070 | Robert Michael Greenberg | Psychiatry & Neurology | 535 Morris Ave, Springfield, NJ 07081-1038 | 2006-11-14 |
| 1750464491 | Shailaja K. Shah | Psychiatry & Neurology | 407 Omni Dr, Hillsborough, NJ 08844-4527 | 2006-10-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.