Provider Demographics
NPI:1215748843
Name:KUZOIAN, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KUZOIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12202 KYLER LN
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-1624
Mailing Address - Country:US
Mailing Address - Phone:860-463-8613
Mailing Address - Fax:
Practice Address - Street 1:2970 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124-3037
Practice Address - Country:US
Practice Address - Phone:703-574-7510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110010556363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant