Individual
MRS. LISA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
110 BUSINESS PARK DR, UTICA, NY 13502-6302
(315) 624-7000
(315) 735-5226
Mailing address
110 BUSINESS PARK DR, UTICA, NY 13502-6302
(315) 624-7000
(315) 735-5226
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F301118-1
NY
Other
Enumeration date
11/22/2005
Last updated
07/08/2010
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