Individual
MRS. ALEXA LOUISE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 GARDEN BLVD, HICKSVILLE, NY 11801-5925
(516) 902-1103
Mailing address
2 GARDEN BLVD, HICKSVILLE, NY 11801-5925
(516) 902-1103
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
697052
NY
Other
Enumeration date
01/14/2014
Last updated
01/14/2014
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