Provider Demographics
NPI:1407033681
Name:OCASIO, WENDELL CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDELL
Middle Name:CARLOS
Last Name:OCASIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10002 MARSHALL POND RD
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3709
Mailing Address - Country:US
Mailing Address - Phone:703-323-0780
Mailing Address - Fax:
Practice Address - Street 1:10002 MARSHALL POND RD
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-3709
Practice Address - Country:US
Practice Address - Phone:703-323-0780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239401208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery