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General NPI Number Information
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NPI Number | 1508812702
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Entity Type | Individual
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Provider Name | IRENE G. RESTAINO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 601 CHILDRENS LN
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City | NORFOLK
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State | VA
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Zip | 23507-1910
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Country | US
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Telephone | 757-668-7244
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Fax | 757-668-9814
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Provider Business Mailing Address
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Address Line | PO BOX 79137
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City | BALTIMORE
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State | MD
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Zip | 21279-0137
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Country | US
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Telephone | 757-668-7200
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Fax | 757-668-9691
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | 0101048592
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101048592
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License Number State | VA
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