Provider Demographics
NPI:1558485474
Name:TSITOS, TONY (MD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:
Last Name:TSITOS
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 1:7501 LITTLE RIVER TPKE
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2923
Mailing Address - Country:US
Mailing Address - Phone:703-941-5555
Mailing Address - Fax:
Practice Address - Street 1:7501 LITTLE RIVER TPKE
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2923
Practice Address - Country:US
Practice Address - Phone:703-941-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101018078204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA409742Medicare ID - Type Unspecified