Michael David Sullivan

NPI #1366918617 in Ithaca, New York

Provider Information

NPI Number: 1366918617
Entity Type: Individual
Name: Michael David Sullivan
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Enumeration Date: Oct 15, 2018
Last Updated: Apr 27, 2019

Practice Location

Address: 403 1/2 HECTOR ST
City: Ithaca
State: New York
ZIP Code: 14850-2025
Phone: (724) 704-1719

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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