Healthcare Provider Details

I. General information

NPI: 1053392092
Provider Name (Legal Business Name): EMILY A LOZANO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 TOWN CENTER PKWY RESTON HOSPITAL CENTER
RESTON VA
20190-3219
US

IV. Provider business mailing address

1300 PICCARD DR SUIT 202
ROCKVILLE MD
20850-4303
US

V. Phone/Fax

Practice location:
  • Phone: 703-689-9037
  • Fax: 703-689-9109
Mailing address:
  • Phone: 301-921-7900
  • Fax: 301-921-7915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101232869
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: