Individual
LEO P SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 MIDDLE SETTLEMENT ROAD, SUITE 208, NEW HARTFORD, NY 13413
(315) 797-3430
(315) 624-7383
Mailing address
4401 MIDDLE SETTLEMENT ROAD, SUITE 208, NEW HARTFORD, NY 13413
(315) 797-3430
(315) 624-7383
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
165823-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01134596
—
NY
Enumeration date
10/31/2005
Last updated
02/17/2012
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