Individual
JORDAN SCOTT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
325 PRINCETON AVE, PRINCETON, NJ 08540-1617
(609) 924-8131
(609) 924-8532
Mailing address
325 PRINCETON AVE, PRINCETON, NJ 08540-1617
(609) 924-8131
(609) 924-8532
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00670500
NJ
363A00000X
Physician Assistant
PA00968
RI
Other
Enumeration date
04/03/2017
Last updated
10/12/2023
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