Individual
MARIE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1001 WEST STREET, CARTHAGE, NY 13619
(315) 493-1000
Mailing address
345 S CLINTON ST, APT. #4, CARTHAGE, NY 13619-1508
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
211318
NY
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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