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Organization

LORRAINE SULLIVAN, NURSE PRACTITIONER PSYCHIATRY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORRAINE SULLIVAN (NURSE PRACTITIONER)
(516) 810-0475
Entity
Organization

Contact information

Practice address
20 MONTAUK HWY, BLUE POINT, NY 11715-1139
(516) 810-0475
Mailing address
756 BLUE RIDGE DR, MEDFORD, NY 11763-1209

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400014
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02362756
NY
Enumeration date
09/08/2014
Last updated
09/08/2014
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