Individual
ANN MARIE THERESA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
80TH ST & 41ST AVE, ELMHURST, NY 11373
(718) 334-3900
(718) 334-5958
Mailing address
44 HOLLAND AVE, FL 8, ALBANY, NY 12208-3411
(518) 474-4403
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
124480
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00246075
—
NY
Enumeration date
04/04/2007
Last updated
05/12/2016
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