Distasio, Anthony J
Distasio, Anthony J is an individual health care provider with primary practice located at 600 Gresham Dr Ste 204 , Norfolk VA 23507-1904. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Trauma. Allopathic & Osteopathic Physicians / Orthopaedic Trauma is his primary health care specialty. Distasio, Anthony J can be contacted via phone (757) 388-5680.Contact Information
Primary practice address
600 Gresham Dr Ste 204
Norfolk VA 23507-1904
Phone: (757) 388-5680
Fax: (757) 388-5681
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 0101041449 | Virginia |
| Allopathic & Osteopathic Physicians / Orthopaedic Trauma | 207XX0801X | 0101041449 | Virginia |
Profile Details
| NPI number | 1831195353 |
|---|---|
| LBN Legal business name | Distasio, Anthony J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Apr 14th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831195353 | NPPES |
| Virginia | MEDICAID | 007306091 |
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