Provider Demographics
NPI:1093020588
Name:RESTO, PATRICIA B (BS PHARM, MPH)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:B
Last Name:RESTO
Suffix:
Gender:F
Credentials:BS PHARM, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 J CLYDE MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1820
Mailing Address - Country:US
Mailing Address - Phone:757-599-6264
Mailing Address - Fax:757-599-6704
Practice Address - Street 1:600 J CLYDE MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1820
Practice Address - Country:US
Practice Address - Phone:757-599-6264
Practice Address - Fax:757-599-6704
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020072921835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA02OtherN