Provider Demographics
NPI:1295588770
Name:RESTAINO, ANTHONY COLE
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:COLE
Last Name:RESTAINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 S BEAL AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-4147
Mailing Address - Country:US
Mailing Address - Phone:704-340-6498
Mailing Address - Fax:
Practice Address - Street 1:6520 S BEAL AVE APT 7
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-4147
Practice Address - Country:US
Practice Address - Phone:704-340-6498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program