Organization
NORMA SULLIVAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NORMA CECILIA SULLIVAN (REGISTERED NURSE)
(718) 592-8275
Entity
Organization
Contact information
Practice address
6115 98TH ST APT 1J, REGO PARK, NY 11374-1407
(718) 592-8275
Mailing address
6115 98TH ST APT 1J, REGO PARK, NY 11374-1407
(718) 592-8275
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
315747
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103-28-6038-A
MEDICARE
NY
Enumeration date
02/21/2016
Last updated
04/15/2016
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