Individual
LAWRENCE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NCPSYA
Contact information
Practice address
141 E 88TH ST, NEW YORK, NY 10128-2273
(212) 289-4530
Mailing address
141 E 88TH ST, NEW YORK, NY 10128-2273
(212) 289-4530
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
000284
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000284
STATE LICENSE
NY
Enumeration date
04/03/2007
Last updated
09/26/2012
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