Healthcare Provider Details

I. General information

NPI: 1093569378
Provider Name (Legal Business Name): EMILY ROSE CAPLAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14011 WORTH AVE
WOODBRIDGE VA
22192-4123
US

IV. Provider business mailing address

14011 WORTH AVE
WOODBRIDGE VA
22192-4123
US

V. Phone/Fax

Practice location:
  • Phone: 703-229-0066
  • Fax: 703-426-2268
Mailing address:
  • Phone: 703-229-0066
  • Fax: 703-426-2268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110012007
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0009265
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: