Provider Demographics
NPI:1447973946
Name:CULLINA, SUZANNE DEMALLIE (PT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:DEMALLIE
Last Name:CULLINA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001-A LANGSTON BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207
Mailing Address - Country:US
Mailing Address - Phone:571-970-6068
Mailing Address - Fax:
Practice Address - Street 1:5001-A LANGSTON BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207
Practice Address - Country:US
Practice Address - Phone:571-970-6068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist