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Contact Information

JUAN L RIESTRA, MD
70 PARK ST
MONTCLAIR, NJ07042-5907
 Phone: 973-655-9300
 Fax: 973-439-5780
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for JUAN L RIESTRA · (Male)

NPI Number 1841255320
Status Active
Credentials MD
Entity Individual
Enumeration date 04/19/2006
Last updated 08/30/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 25MA05785800
  • NJ Medicaid 7886802
Hospital affiliation(s)
  • HACKENSACK UMC MOUNTAINSIDE - (Acute Care)
    BAY AND HIGHLAND AVE
    MONTCLAIR, NJ 07042
  • ST JOSEPH'S REGIONAL MEDICAL CENTER - (Acute Care)
    703 MAIN ST
    PATERSON, NJ 07503
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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