Provider Demographics
NPI:1669113981
Name:GRIFFITH, SUSAN PAGE (COTA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:PAGE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:PAGE
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:4212 39TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-4600
Mailing Address - Country:US
Mailing Address - Phone:703-927-3456
Mailing Address - Fax:
Practice Address - Street 1:5255 LOUGHBORO RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2633
Practice Address - Country:US
Practice Address - Phone:202-537-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-03
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOTA52208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation