Organization
BHEALTHYRN LLC
Active
Other names
360 Med
Organization subpart
No
Provider details
NPI number
Authorized official
BEVIN ANNE SULLIVAN AGACNP (OWNER/PROVIDER)
(718) 450-0172
Entity
Organization
Contact information
Practice address
31 TIOGA STREET, GROUND FLOOR, STATEN ISLAND, NY 10301-4352
(718) 450-0172
Mailing address
31 TIOGA STREET, GROUND FLOOR, STATEN ISLAND, NY 10301-4352
(718) 450-0172
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
06/26/2024
Last updated
09/03/2024
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