Organization
FITNESS & RECOVERY MEDICAL PRACTICE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MACK LEE SULLIVAN (M.D.)
(914) 395-3691
Entity
Organization
Contact information
Practice address
369 WHITE PLAINS RD STE B, EASTCHESTER, NY 10709-2805
(914) 395-3691
(914) 395-3693
Mailing address
369 WHITE PLAINS RD STE B, EASTCHESTER, NY 10709-2805
(914) 395-3691
(914) 395-3693
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
203477
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
203477
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203477
LICENSE
NY
Enumeration date
01/12/2009
Last updated
09/10/2025
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