Individual
JOAN M SULLIVAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20 ARROWOOD DR, ITHACA, NY 14850-1857
(607) 266-7800
Mailing address
102 HORIZON DR, ITHACA, NY 14850-9791
(607) 257-1014
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
186213
NY
Other
Enumeration date
07/21/2005
Last updated
07/08/2007
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