Individual
ADINA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2 MUR PL, BRENTWOOD, NY 11717-2934
(631) 972-2457
(631) 972-1547
Mailing address
2 MUR PL, BRENTWOOD, NY 11717-2934
(631) 972-2457
(631) 972-1547
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
635924-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
635924-1
REGISTERED NURSE
NY
Enumeration date
04/15/2021
Last updated
04/15/2021
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