Organization
INITIA NOVA MEDICAL SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK O SULLIVAN D.O. (OWNER)
(856) 625-8563
Entity
Organization
Contact information
Practice address
1930 MARLTON PIKE E, CHERRY HILL, NJ 08003-2150
(856) 446-6961
Mailing address
1930 MARLTON PIKE E, CHERRY HILL, NJ 08003-2150
(856) 446-6961
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
25MB08239800
NJ
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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