Healthcare Provider Details

I. General information

NPI: 1992785331
Provider Name (Legal Business Name): WILLIAM A INCATASCIATO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 HUNTMAR PARK DR STE 100
HERNDON VA
20170-5141
US

IV. Provider business mailing address

505 HUNTMAR PARK DR STE 100
HERNDON VA
20170-5141
US

V. Phone/Fax

Practice location:
  • Phone: 703-359-5100
  • Fax: 844-271-8010
Mailing address:
  • Phone: 703-359-5100
  • Fax: 844-271-8010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number010105012
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: