Individual
DR. EDWIN J SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO FACOS
Contact information
Practice address
449 B MARKET ST, SUITE B, SADDLE BROOK, NJ 07663-8941
(201) 843-7942
(201) 712-7902
Mailing address
449 B MARKET ST, SUITE B, SADDLE BROOK, NJ 07663-8941
(201) 843-7942
(201) 712-7902
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MB25068
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1464906
—
NJ
Enumeration date
06/27/2006
Last updated
07/08/2007
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