Provider Demographics
NPI:1710093067
Name:ANTOCI, VALENTIN (MD)
Entity Type:Individual
Prefix:
First Name:VALENTIN
Middle Name:
Last Name:ANTOCI
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:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-0629
Mailing Address - Country:US
Mailing Address - Phone:509-837-1570
Mailing Address - Fax:509-837-2236
Practice Address - Street 1:2925 ALLEN RD
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-8931
Practice Address - Country:US
Practice Address - Phone:509-837-1570
Practice Address - Fax:509-837-2236
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD20006-0165207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery