National Provider Identifier
Michelle M Sullivan
Michelle M Sullivan is listed in the NPPES registry with a primary specialty of Physical Therapy Assistant in Newark, NY and a listed phone number of (315) 331-7741.
Profile Overview
- NPI
- 1265761654
- Provider Type
- Individual
- Primary Specialty
- Physical Therapy Assistant
- Enumeration Date
- December 14, 2009
- Last Updated
- December 14, 2009
Practice Location
- 150 Van Buren St
- Newark, NY 14513-1238
Phone: (315) 331-7741
Specialties
- Physical Therapy Assistant (225200000X)
Full Record
- NPI
- 1265761654
- Entity Type
- Individual
- Last Name
- Sullivan
- First Name
- Michelle
- Middle Name
- M
- Provider Other Last Name
- Aubertine
- Provider Other First Name
- Michelle
- Provider Other Middle Name
- M
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 150 Van Buren St
- Mailing City
- Newark
- Mailing State
- NY
- Mailing ZIP Code
- 14513-1238
- Mailing Country
- US
- Mailing Phone
- (315) 331-7741
- Mailing Fax
- (315) 331-0566
- Practice Street Address
- 150 Van Buren St
- Practice City
- Newark
- Practice State
- NY
- Practice ZIP Code
- 14513-1238
- Practice Country
- US
- Practice Phone
- (315) 331-7741
- Practice Fax
- (315) 331-0566
- Enumeration Date
- December 14, 2009
- Last Updated
- December 14, 2009
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapy Assistant (225200000X)