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Individual

JODI-LYNN SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
24 HOSPITAL AVE, DANBURY, CT 06810-6099
(203) 797-7118
Mailing address
443 PLATTEKILL ARDONIA RD, WALLKILL, NY 12589-4636
(845) 597-9963

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
90925
NY

Other

Enumeration date
11/28/2012
Last updated
01/02/2013
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