Provider Demographics
NPI:1063628683
Name:CAPLAN, JUDY ELLEN (R,D)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:ELLEN
Last Name:CAPLAN
Suffix:
Gender:F
Credentials:R,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 TWIN MILL LN
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1022
Mailing Address - Country:US
Mailing Address - Phone:703-758-2399
Mailing Address - Fax:703-648-0926
Practice Address - Street 1:11440 COMMERCE PARK DR
Practice Address - Street 2:SUITE LL1A
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1555
Practice Address - Country:US
Practice Address - Phone:703-860-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA948130133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA948130OtherCOM. ON DIETETIC REGISTRA