| Doctor Name: | MRS. PATRICIA ANN SULLIVAN |
| NPI Number: | 1194816637 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP/FNP |
| License Number: | F3401241 |
| Business Practice Address: | 4 Weber Ave Malverne, NY - 115651742 |
| Business Phone Number: | 5165995885 |
| Business Fax Number: | 5165995442 |
| Mailing Address: | 77 Kirkwood St, LONG BEACH |
| State: | NY |
| Postal Code: | 11561 |
| Phone Number: | 5164592497 |
| Fax Number: | 5168890159 |
| NPI Enumeration Date: | 09/28/2006 |
| NPI Last Update Date: | 04/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | F3401241 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |