Individual
MS. SUSAN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
141 E MAIN ST, HUNTINGTON, NY 11743-2852
(631) 351-8374
Mailing address
141 E MAIN ST, HUNTINGTON, NY 11743-2852
(631) 351-8374
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400044-1
NY
Other
Enumeration date
03/22/2006
Last updated
01/15/2016
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