Individual
DAVID SULLIVAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
5300 KIDSPEACE DR, OREFIELD, PA 18069-2000
(800) 854-3123
Mailing address
16 CACTUS LN, READING, PA 19606-9313
(484) 554-9180
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP022527
PA
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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