Individual
JENNIFER M SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
88 SLOCUM AVE, TAPPAN, NY 10983-2610
(914) 329-4982
Mailing address
88 SLOCUM AVE, TAPPAN, NY 10983-2610
(914) 329-4982
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
222Q00000X
Developmental Therapist
Primary
—
—
246Z00000X
Other Specialist/Technologist
—
—
Other
Enumeration date
03/03/2015
Last updated
09/21/2017
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