Individual
MRS. VICTORIA MARY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
55 LOCK ST, NEW HAVEN, CT 06511-3603
(203) 432-0123
Mailing address
93 LACEY RD, BETHANY, CT 06524-3021
(203) 520-4210
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
016001
NY
363A00000X
Physician Assistant
Primary
3031
CT
Other
Enumeration date
10/01/2012
Last updated
02/22/2019
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