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General NPI Number Information
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NPI Number | 1205654969
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Entity Type | Individual
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Provider Name | TERRI RYAN SULLIVAN RDH
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Gender | Female
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | MONROE COMMUNITY HOSPITAL 435 E HENRIETTA RD
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City | ROCHESTER
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State | NY
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Zip | 14620
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Country | US
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Telephone | 585-760-6040
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Fax |
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Provider Business Mailing Address
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Address Line | 24 HUNT HOLW
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City | ROCHESTER
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State | NY
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Zip | 14624-4370
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Country | US
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Telephone | 585-794-3442
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 021097-01
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License Number State | NY
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