Individual
TIMOTHY ERIC SULLIVAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2160 STATE RD, LANCASTER, PA 17601-1812
(223) 287-8155
(717) 312-3143
Mailing address
307 LAKESIDE XING, MOUNT JOY, PA 17552-9061
(717) 598-8531
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
25MP00271500
NJ
363AM0700X
Medical Physician Assistant
Primary
MA056911
PA
Other
Enumeration date
11/08/2011
Last updated
05/26/2026
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