Provider Demographics
NPI:1235372293
Name:SULLIVAN, FRANCIS BRENDAN (PA)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:BRENDAN
Last Name:SULLIVAN
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Gender:M
Credentials:PA
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 1136
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-241-0050
Mailing Address - Fax:212-410-0603
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:BOX 1136
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-241-0050
Practice Address - Fax:212-410-0603
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
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Provider Licenses
StateLicense IDTaxonomies
NY005724-1363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical