Provider Demographics
NPI:1992785331
Name:INCATASCIATO, WILLIAM A (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:INCATASCIATO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14 PIDGEON HILL DRIVE
Mailing Address - Street 2:STE. 130
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165
Mailing Address - Country:US
Mailing Address - Phone:703-444-1144
Mailing Address - Fax:703-444-6679
Practice Address - Street 1:14 PIDGEON HILL DRIVE
Practice Address - Street 2:STE. 130
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165
Practice Address - Country:US
Practice Address - Phone:703-444-1144
Practice Address - Fax:703-444-6679
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2012-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA010105012208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006730337Medicaid