| Doctor Name: | CYNTHIA A SULLIVAN |
| NPI Number: | 1194889683 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, NPC |
| License Number: | 163WA0400X |
| Business Practice Address: | 408 Bethel Rd Bldg B Suite 2 Somers Point, NJ - 082442172 |
| Business Phone Number: | 6095933076 |
| Business Fax Number: | 6098615373 |
| Mailing Address: | 408 Bethel Rd, Bldg B Suite 2 SOMERS POINT |
| State: | NJ |
| Postal Code: | 082442172 |
| Phone Number: | 6094086002 |
| Fax Number: | 6098612131 |
| NPI Enumeration Date: | 12/20/2006 |
| NPI Last Update Date: | 10/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA0400X |
| License Number: | 163WA0400X |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |