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Organization
CHANTILLY SPECIALISTS, LTD. OF VIRGINIA
Active
Organization
CHANTILLY SPECIALISTS, LTD. OF VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL BOCCONE J.D., LL.M. (PRESIDENT)
(703) 378-3854
Entity
Organization
Contact information
Practice address
4200 LAFAYETTE CENTER DR, STE R, CHANTILLY, VA 20151-1241
(703) 378-3854
(703) 378-4909
Mailing address
4200 LAFAYETTE CENTER DR, STE R, CHANTILLY, VA 20151-1241
(703) 378-3854
(703) 378-4909
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
03/25/2010
Last updated
02/22/2011
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