Individual
PAUL EDWARD SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
999 ROUTE 73 N STE 401, MARLTON, NJ 08053-1227
(800) 321-9999
(267) 479-1321
Mailing address
833 CHESTNUT ST STE 520, PHILADELPHIA, PA 19107-4430
(800) 321-9999
(267) 339-3761
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
SC003899L
PA
213ES0131X
Foot Surgery Podiatrist
Primary
25MD00267000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8925704
—
NJ
Enumeration date
06/22/2005
Last updated
02/28/2022
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