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Individual
MEGAN ALISE SULLIVAN
Active
Individual
MEGAN ALISE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
064286
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
331335
NY
Other
Enumeration date
04/18/2018
Last updated
02/20/2025
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