National Provider Identifier
Alyssa Sullivan
Alyssa Sullivan is listed in the NPPES registry with a primary specialty of Dentist in Brockport, NY and a listed phone number of (585) 636-0555.
Profile Overview
- NPI
- 1699238691
- Provider Type
- Individual
- Primary Specialty
- Dentist
- Enumeration Date
- April 08, 2019
- Last Updated
- January 09, 2021
Practice Location
- 1000 Transit Way
- Brockport, NY 14420-3008
Phone: (585) 636-0555
Specialties
- Dentist (122300000X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1699238691
- Entity Type
- Individual
- Last Name
- Sullivan
- First Name
- Alyssa
- Mailing Street Address
- 1000 Transit Way
- Mailing City
- Brockport
- Mailing State
- NY
- Mailing ZIP Code
- 14420-3008
- Mailing Country
- US
- Mailing Phone
- (585) 636-0555
- Practice Street Address
- 1000 Transit Way
- Practice City
- Brockport
- Practice State
- NY
- Practice ZIP Code
- 14420-3008
- Practice Country
- US
- Practice Phone
- (585) 636-0555
- Enumeration Date
- April 08, 2019
- Last Updated
- January 09, 2021
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- December 30, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X), Student in an Organized Health Care Education/Training Program (390200000X)