Individual
ANNE MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1528 WALNUT ST STE 950, PHILADELPHIA, PA 19102-3628
(267) 273-1196
(267) 273-1193
Mailing address
1500 LOCUST ST APT 3406, PHILADELPHIA, PA 19102-4323
(717) 404-9328
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA061897
PA
Other
Enumeration date
09/23/2020
Last updated
10/12/2020
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