Individual provider · Type 1 NPI
Debra Sullivan, PA
Medical Physician Assistant · Derby, CT
NPI number
1396836714
Active
Practice location
130 Divsiion Street
Derby, CT 06418
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 001807 (CT) |
Medical Physician Assistant: Definition to come...
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About NPI 1396836714
Debra Sullivan, PA's National Provider Identifier is 1396836714, issued on Sep 28, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Derby, CT. The record was last updated on Jul 8, 2007.