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General NPI Number Information
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NPI Number | 1508900531
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Entity Type | Organization
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Legal Business Name | DR PAUL E SULLIVAN
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 2089 KLOCKNER RD
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City | HAMILTON
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State | NJ
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Zip | 08690-3416
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Country | US
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Telephone | 609-324-2900
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Fax | 609-324-7156
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Provider Business Mailing Address
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Address Line | 2089 KLOCKNER RD
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City | HAMILTON
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State | NJ
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Zip | 08690-3416
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Country | US
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Telephone | 609-890-6544
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Fax | 609-890-6588
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. PAUL EDWARD SULLIVAN
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Credential | D.P.M
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Telephone | 609-890-6544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 25MD00267000
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License Number State | NJ
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