Individual
AMANDA B O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
225 MERRICK RD, LYNBROOK, NY 11563-2621
(516) 599-8734
Mailing address
47 CATHERINE ST, VALLEY STREAM, NY 11581-1316
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003587
NY
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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