Individual
KATHLEEN E SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D. PHD
Contact information
Practice address
3550 MARKET ST FL 3, CHILDREN'S HOSPITAL OF PHILADELPHIA - ALLERGY & IMMUN, PHILADELPHIA, PA 19104-3365
(215) 590-2549
(215) 590-4529
Mailing address
100 E PENN SQ, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9258
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD050758L
PA
2080I0007X
Pediatric Clinical & Laboratory Immunology Physician
MD050758L
PA
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
MD050758L
PA
2080P0216X
Pediatric Rheumatology Physician
MD050758L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001431101
—
PA
05
—
5617308
—
NJ
Enumeration date
08/02/2006
Last updated
10/30/2014
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