Provider Demographics
NPI:1538346044
Name:LINDA RESTO OD PC
Entity type:Organization
Organization Name:LINDA RESTO OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RESTO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:845-567-0174
Mailing Address - Street 1:152 CHANDLER LN
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-1729
Mailing Address - Country:US
Mailing Address - Phone:845-800-6969
Mailing Address - Fax:
Practice Address - Street 1:1201 ROUTE 300
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5005
Practice Address - Country:US
Practice Address - Phone:845-567-0174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004931-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty