Chantilly Specialists, Ltd. of Virginia

NPI #1497079073 in Chantilly, Virginia

Provider Information

NPI Number: 1497079073
Entity Type: Organization
Organization Name: Chantilly Specialists, Ltd. of Virginia
Primary Specialty: Pain Medicine - Pain Medicine
Enumeration Date: Mar 25, 2010
Last Updated: Feb 22, 2011

Practice Location

Address: 4200 LAFAYETTE CENTER DR
Address 2: STE R
City: Chantilly
State: Virginia
ZIP Code: 20151-1241
Phone: (703) 378-3854

Authorized Official

Name: MR. PAUL BOCCONE, J.D., LL.M.
Title: PRESIDENT
Phone: (703) 378-3854

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Pain Medicine - Pain Medicine — Pain Medicine	208VP0000X	Primary

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