Provider Demographics
NPI:1699435271
Name:KOTIAN, CAITLIN E FORGIONE
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:E FORGIONE
Last Name:KOTIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ELIZABETH
Other - Last Name:FORGIONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:401 CAMPUS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2800
Mailing Address - Country:US
Mailing Address - Phone:540-536-3021
Mailing Address - Fax:
Practice Address - Street 1:401 CAMPUS BLVD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2800
Practice Address - Country:US
Practice Address - Phone:540-536-3021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist