Provider Demographics
NPI:1962421156
Name:RESTIFO, MARY D (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:D
Last Name:RESTIFO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3301 NEW MEXICO AVE NW
Mailing Address - Street 2:SUITE 348
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3622
Mailing Address - Country:US
Mailing Address - Phone:202-362-4467
Mailing Address - Fax:202-364-6513
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:SUITE 348
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3622
Practice Address - Country:US
Practice Address - Phone:202-362-4467
Practice Address - Fax:202-364-6513
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD6165207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
163712Medicare ID - Type Unspecified
B93842Medicare UPIN