Individual
MISS JUDITH ANN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2453 MORGAN AVE, BRONX, NY 10469-5705
(718) 882-5240
Mailing address
320 E 70TH ST, # 102, NEW YORK, NY 10021-8629
(212) 592-4066
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
239541-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01555462
—
NY
Enumeration date
03/06/2007
Last updated
07/09/2007
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