| Doctor Name: | MISS CARYN ELISABETH SULLIVAN |
| NPI Number: | 1174970305 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN-C |
| License Number: | 26NJ00641200 |
| Business Practice Address: | 600 Jessup Rd West Deptford, NJ - 080662413 |
| Business Phone Number: | 8568454061 |
| Business Fax Number: | |
| Mailing Address: | 75 Tarragon Ct, WEST DEPTFORD |
| State: | NJ |
| Postal Code: | 080862418 |
| Phone Number: | 6092217781 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2016 |
| NPI Last Update Date: | 05/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 26NJ00641200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |