Organization
FITNESS AND RECOVERY MEDICAL PRACTICE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MACK LEE SULLIVAN MD (DIRECTOR OF OPERATIONS)
(914) 395-3691
Entity
Organization
Contact information
Practice address
369 WHITE PLAINS RD, EASTCHESTER, NY 10709-2805
(914) 395-3691
Mailing address
369 WHITE PLAINS RD, EASTCHESTER, NY 10709-2805
(914) 395-3691
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
018927-1
NY
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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