Individual provider · Type 1 NPI

Jacqueline Gloria Sullivan, PA

Physician Assistant · Bronx, NY

NPI number 1104051549 Active

Practice location

111 E 210th St
Bronx, NY 10467-2401

Call (718) 920-4321 Map

Mailing address

232 Springmeadow Dr, Unit C
Holbrook, NY 11741-4137

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104051549

Jacqueline Gloria Sullivan, PA's National Provider Identifier is 1104051549, issued on May 28, 2009. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Bronx, NY. The record was last updated on May 28, 2009.