MRS. Tara Marie Sullivan
NPI #1205199601 in Whitestone, New York
Provider Information
- NPI Number
- 1205199601
- Entity Type
- Individual
- Name
- MRS. Tara Marie Sullivan
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Enumeration Date
- Jun 20, 2012
- Last Updated
- Jun 20, 2012
Practice Location
- Address
- 14911 12TH AVE
- City
- Whitestone
- State
- New York
- ZIP Code
- 11357-1725
- Phone
- (516) 576-2040
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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