Individual
MRS. LISA MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
110 FORT COUCH RD, SUITE 203, PITTSBURGH, PA 15241-1030
(412) 831-3300
Mailing address
721 ROSELAWN AVE, UNIT C6, MT LEBANON, PA 15228-2260
(716) 523-4048
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/03/2013
Last updated
01/31/2014
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