Individual
DR. TICONI ANTOINE BARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
11484 WASHINGTON PLZ W, SUITE 300, RESTON, VA 20190-4344
(703) 787-3219
(703) 481-3853
Mailing address
418 OLD DOMINION AVE, HERNDON, VA 20170-5323
(703) 471-1219
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0102050121
VA
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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