| Doctor Name: | PAUL SULLIVAN |
| NPI Number: | 1245695402 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DPT |
| License Number: | 40QA01649500 |
| Business Practice Address: | 34 Manchester Ave Forked River, NJ - 087311366 |
| Business Phone Number: | 6096939345 |
| Business Fax Number: | 6096939347 |
| Mailing Address: | 833 Chestnut St, Ste 1402 PHILADELPHIA |
| State: | PA |
| Postal Code: | 191074404 |
| Phone Number: | 8003219999 |
| Fax Number: | 2673393761 |
| NPI Enumeration Date: | 12/15/2015 |
| NPI Last Update Date: | 06/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 40QA01649500 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |