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Individual

COURTNEY SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., RRA, RT(R), RD

Contact information

Practice address
520 E 70TH ST, NEW YORK, NY 10021-9800
(212) 746-3776
Mailing address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-3776

Taxonomy

Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
7917287
NY
2471C3402X
Radiography Radiologic Technologist
111056
NY

Other

Enumeration date
07/11/2013
Last updated
07/11/2013
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