| Doctor Name: | BARBARA SULLIVAN |
| NPI Number: | 1023033396 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.N.P. |
| License Number: | F380017 |
| Business Practice Address: | 21 Willow Pond Way Ste 200 Penfield, NY - 145262687 |
| Business Phone Number: | 5853770840 |
| Business Fax Number: | 5853779715 |
| Mailing Address: | 21 Willow Pond Way, Ste 200 PENFIELD |
| State: | NY |
| Postal Code: | 145262687 |
| Phone Number: | 5853770840 |
| Fax Number: | 5853779715 |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0200X |
| License Number: | F380017 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |