Organization
FITNESS & RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MACK LEE SULLIVAN M.D. (PRESIDENT)
(914) 395-3691
Entity
Organization
Contact information
Practice address
150 LAKE AVE, TUCKAHOE, NY 10707-3306
(914) 395-3691
(914) 395-3693
Mailing address
150 LAKE AVE, TUCKAHOE, NY 10707-3306
(914) 395-3691
(914) 395-3693
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
203477
NY
Other
Enumeration date
02/20/2008
Last updated
09/04/2008
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