National Provider Identifier
Grant E Sullivan, RPH
Grant E Sullivan, RPH is listed in the NPPES registry with a primary specialty of Pharmacist in Ithaca, NY and a listed phone number of (607) 273-3647.
Profile Overview
- NPI
- 1023135944
- Provider Type
- Individual
- Primary Specialty
- Pharmacist
- Enumeration Date
- March 24, 2007
- Last Updated
- July 18, 2023
Practice Location
- 625 W Clinton St
- Ithaca, NY 14850-5235
Phone: (607) 273-3647
Specialties
- Pharmacist (183500000X)
Full Record
- NPI
- 1023135944
- Entity Type
- Individual
- Last Name
- Sullivan
- First Name
- Grant
- Middle Name
- E
- Credential
- RPH
- Mailing Street Address
- 625 W Clinton St
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-5235
- Mailing Country
- US
- Mailing Phone
- (607) 273-3647
- Practice Street Address
- 625 W Clinton St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5235
- Practice Country
- US
- Practice Phone
- (607) 273-3647
- Enumeration Date
- March 24, 2007
- Last Updated
- July 18, 2023
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- July 18, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pharmacist (183500000X)