Provider Demographics
NPI:1760771570
Name:GRIFFITH, PAMELA K (COTA)
Entity Type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:K
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12125 COUNTYLINE ROAD
Mailing Address - Street 2:
Mailing Address - City:YORKSHIRE
Mailing Address - State:NY
Mailing Address - Zip Code:14173
Mailing Address - Country:US
Mailing Address - Phone:716-492-9300
Mailing Address - Fax:
Practice Address - Street 1:12125 COUNTYLINE ROAD
Practice Address - Street 2:
Practice Address - City:YORKSHIRE
Practice Address - State:NY
Practice Address - Zip Code:14173
Practice Address - Country:US
Practice Address - Phone:716-492-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003403-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant