National Provider Identifier
John K Sullivan, M.D.
John K Sullivan, M.D. is listed in the NPPES registry with a primary specialty of Emergency Medicine Physician in Bath, NY and a listed phone number of (607) 664-4000.
Profile Overview
- NPI
- 1235228743
- Provider Type
- Individual
- Primary Specialty
- Emergency Medicine Physician
- Enumeration Date
- October 12, 2006
- Last Updated
- September 19, 2025
Practice Location
- 76 Veterans Ave
- Bath, NY 14810
Phone: (607) 664-4000
Mailing Address
- 418 N Main St
- Penn Yan, NY 14527-1070
Specialties
- Emergency Medicine Physician (207P00000X)
Full Record
- NPI
- 1235228743
- Entity Type
- Individual
- Last Name
- Sullivan
- First Name
- John
- Middle Name
- K
- Credential
- M.D.
- Mailing Street Address
- 418 N Main St
- Mailing City
- Penn Yan
- Mailing State
- NY
- Mailing ZIP Code
- 14527-1070
- Mailing Country
- US
- Practice Street Address
- 76 Veterans Ave
- Practice City
- Bath
- Practice State
- NY
- Practice ZIP Code
- 14810
- Practice Country
- US
- Practice Phone
- (607) 664-4000
- Practice Fax
- (607) 664-4791
- Enumeration Date
- October 12, 2006
- Last Updated
- September 19, 2025
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- September 19, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Emergency Medicine Physician (207P00000X)
- Other Identifiers
- J400006577 (NY, Ptan-North Medical, PC)