# LORRAINE SULLIVAN, NURSE PRACTITIONER PSYCHIATRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164823340
- **Authorized official:** LORRAINE SULLIVAN (NURSE PRACTITIONER)
- **Authorized official phone:** (516) 810-0475

## Contact information

- **Practice address:** 20 MONTAUK HWY, BLUE POINT, NY 11715-1139
- **Practice address phone:** (516) 810-0475
- **Mailing address:** 756 BLUE RIDGE DR, MEDFORD, NY 11763-1209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | F400014 | NY | Yes |

## Other

- **Enumeration date:** 09/08/2014
- **Last updated:** 09/08/2014