Individual
MS. MARY CECILIA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN
Contact information
Practice address
1 ELMCROFT RD, STAMFORD, CT 06926-0700
(203) 351-7700
Mailing address
1 ELMCROFT RD, STAMFORD, CT 06926-0700
(203) 351-7700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
001625
CT
363LP0200X
Pediatric Nurse Practitioner
F380181-1
NY
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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