MEDICARE: REAGAN O'SULLIVAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		NY

General Provider Information

NPI Number	:	1447187596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REAGAN O'SULLIVAN

Provider Business Mailing Address
First Line	:	5 CARE LN STE 102
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-8623
Country	:	US
Telephone Number	:	518-587-5670
Fax Number	:	518-587-5674

Provider Business Practice Location Address
First Line	:	5 CARE LN
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-8623
Country	:	US
Telephone Number	:	518-587-5670
Fax Number	:	518-587-5674

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “ REAGAN O'SULLIVAN ” Practice Location

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