Organization
STANFORD N. SULLUM MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANFORD N SULLUM M.D. (OWNER)
(212) 876-4630
Entity
Organization
Contact information
Practice address
1136 5TH AVE, 1B, NEW YORK, NY 10128-0122
(212) 876-4630
(212) 876-3478
Mailing address
1136 5TH AVE, 1B, NEW YORK, NY 10128-0122
(212) 876-4630
(212) 876-3478
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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