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NPI Code Detail

MEDICARE: BRIANNA HOHMAN SULLIVAN DPT

MEDICARE: BRIANNA HOHMAN SULLIVAN DPT
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
1225100000XPhysical Therapist2305213513VA

General Provider Information

NPI Number : 1558984898
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNA HOHMAN SULLIVAN DPT
Provider Business Mailing Address
First Line : 1377 MOTOR PKWY STE 307
Second Line :
City : ISLANDIA
State : NY
Zip : 11749-5258
Country : US
Telephone Number : 631-580-5200
Fax Number : 631-580-5222
Provider Business Practice Location Address
First Line : 3509 GRANBY ST STE B
Second Line :
City : NORFOLK
State : VA
Zip : 23504-1312
Country : US
Telephone Number : 757-423-8885
Fax Number : 757-423-8886
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2020
Last Update Date : 05/21/2020

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