Healthcare Provider Details

I. General information

NPI: 1881159945
Provider Name (Legal Business Name): CAITLIN RIESS POWERS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLIN GLORIA RIESS PA

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 06/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 YORK ROAD SUITE 100A
LUTHERVILLE MD
21093-6022
US

IV. Provider business mailing address

1447 YORK ROAD SUITE 301
LUTHERVILLE MD
21093-6022
US

V. Phone/Fax

Practice location:
  • Phone: 410-252-9090
  • Fax: 410-494-7064
Mailing address:
  • Phone: 410-252-9090
  • Fax: 410-494-7064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC0007027
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: