Tara Marie Sullivan

NPI 1205199601 - Specialist - 174400000X

NPI Details
NPI 1205199601
Gender Female
Enumeration Date 06/20/2012
Last Updated 06/20/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
14911 12TH AVE
WHITESTONE NY, 11357-1725, US
Phone (516) 576-2040
Fax
Business Location
14911 12TH AVE
WHITESTONE NY, 11357-1725, US
Phone (516) 576-2040
Fax
Toxanomy
Taxonomy Code 174400000X
License State New York
License Number 1718799
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According to our database, Mrs. Tara Marie Sullivan NPI is 1205199601, taxonomy code is 174400000X and license number is 1718799, license state is located at New York. Tara Marie Sullivan physically located at 14911 12th Ave, Whitestone NY, 11357-1725. NPI Number Tara Marie Sullivan has the Individual type.

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1205199601 NPI number is provided on an as is basis without warranty of any kind. 1205199601 is maintained by the National Plan & Provider Enumeration System. The contents of Tara Marie Sullivan are for informational purposes only.