Individual
AMANDA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5871
Mailing address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
752412
NY
Other
Enumeration date
05/10/2023
Last updated
10/20/2025
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