Individual provider · Type 1 NPI

Tara Marie Sullivan

Specialist · Whitestone, NY

NPI number 1205199601 Active

Practice location

14911 12th Ave
Whitestone, NY 11357-1725

Call (516) 576-2040 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X1718799 (NY)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1205199601

Tara Marie Sullivan's National Provider Identifier is 1205199601, issued on Jun 20, 2012. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Whitestone, NY. The record was last updated on Jun 20, 2012.