Individual
MS. IRENE ANNE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1353
(516) 562-6000
Mailing address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576
(516) 562-6000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
302076
NY
Other
Enumeration date
12/04/2009
Last updated
12/04/2009
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