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Individual

JARED M. SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1117 US HIGHWAY 46 STE 202, CLIFTON, NJ 07013-2450
(973) 779-1221
(973) 778-6014
Mailing address
10 PIHLMAN PL, CHATHAM, NJ 07928-2707
(973) 768-7967
(973) 778-6014

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA076546
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0079553
NJ
Enumeration date
10/13/2006
Last updated
07/08/2007
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