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Individual

TAMARA SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1951 ROUTE 302, CIRCLEVILLE MIDDLE SCHOOL, CIRCLEVILLE, NY 10919-0143
(845) 744-2031
(845) 744-4076
Mailing address
PO BOX 143, CIRCLEVILLE, NY 10919-0143

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
272043-1
NY

Other

Enumeration date
11/22/2011
Last updated
11/22/2011
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