Provider Demographics
NPI:1760693782
Name:SUL, JOOHEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOOHEE
Middle Name:
Last Name:SUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOOHEE
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-273-3507
Mailing Address - Fax:585-276-2162
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 704
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-2545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2357672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB4968OtherMEDICARE PTAN ID