National Provider Identifier
Michael David Sullivan
Michael David Sullivan is listed in the NPPES registry with a primary specialty of Social Worker in Ithaca, NY and a listed phone number of (724) 704-1719.
Profile Overview
- NPI
- 1366918617
- Provider Type
- Individual
- Primary Specialty
- Social Worker
- Enumeration Date
- October 15, 2018
- Last Updated
- April 27, 2019
Practice Location
- 403 1/2 Hector St
- Ithaca, NY 14850-2025
Phone: (724) 704-1719
Specialties
- Social Worker (104100000X)
Full Record
- NPI
- 1366918617
- Entity Type
- Individual
- Last Name
- Sullivan
- First Name
- Michael
- Middle Name
- David
- Mailing Street Address
- 403 1/2 Hector St
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-2025
- Mailing Country
- US
- Mailing Phone
- (724) 704-1719
- Practice Street Address
- 403 1/2 Hector St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-2025
- Practice Country
- US
- Practice Phone
- (724) 704-1719
- Enumeration Date
- October 15, 2018
- Last Updated
- April 27, 2019
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Social Worker (104100000X)