Individual
MR. JOSEPH SULLIVAN EDWARD SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
249 GLENWOOD RD, BINGHAMTON, NY 13905-1603
(607) 240-4828
Mailing address
1656 BREWER RD, ONEIDA, NY 13421-9787
(315) 749-6769
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
007413
NY
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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