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Individual

MS. DOROTHY LOUISE SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
301 E 17TH ST, NEW YORK, NY 10003-3804
(212) 598-6000
Mailing address
4 BAYVIEW PL, STATEN ISLAND, NY 10304-2211
(718) 727-9959

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002960
NY

Other

Enumeration date
07/14/2008
Last updated
07/14/2008
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