Provider Demographics
NPI:1952090029
Name:O'SULLIVAN, CARYN (CNS, MS)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:O'SULLIVAN
Suffix:
Gender:F
Credentials:CNS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 BLUE MILL RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7013
Mailing Address - Country:US
Mailing Address - Phone:347-387-5780
Mailing Address - Fax:
Practice Address - Street 1:142 BLUE MILL RD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7013
Practice Address - Country:US
Practice Address - Phone:347-387-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach