Individual
KARYN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
50 LEROY ST, POTSDAM, NY 13676-1786
(315) 782-2620
(315) 788-4980
Mailing address
1116 ARSENAL ST, SUITE 504, WATERTOWN, NY 13601-2229
(315) 782-2620
(315) 788-4980
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
008258-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J400011718
MEDICARE
NY
Enumeration date
08/31/2006
Last updated
04/08/2010
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