National Provider Identifier

Charles Brian Sullivan, PMHNP

Charles Brian Sullivan, PMHNP is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner in Rochester, NY and a listed phone number of (585) 753-4183.

NPI 1447092671Rochester, NYPsychiatric/Mental Health Nurse Practitioner

Profile Overview

NPI
1447092671
Provider Type
Individual
Primary Specialty
Psychiatric/Mental Health Nurse Practitioner
Enumeration Date
June 10, 2024
Last Updated
July 09, 2024

Practice Location

  • 130 S Plymouth Ave
  • Rochester, NY 14614-2209

Phone: (585) 753-4183

Mailing Address

  • 130 S Plymouth Ave
  • Rochester, NY 14614-2213

Specialties

  • Psychiatric/Mental Health Nurse Practitioner (363LP0808X)
Full Record
NPI
1447092671
Entity Type
Individual
Last Name
Sullivan
First Name
Charles
Middle Name
Brian
Credential
PMHNP
Mailing Street Address
130 S Plymouth Ave
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14614-2213
Mailing Country
US
Mailing Phone
(585) 753-4183
Practice Street Address
130 S Plymouth Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14614-2209
Practice Country
US
Practice Phone
(585) 753-4183
Enumeration Date
June 10, 2024
Last Updated
July 09, 2024
Sex
Male
Sole Proprietor
No
Certification Date
July 09, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Psychiatric/Mental Health Nurse Practitioner (363LP0808X)