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General NPI Number Information
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NPI Number | 1588478705
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Entity Type | Individual
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Provider Name | SARAH DANIELLE SULLIVAN NP
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Gender | Female
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 905 GREENE COUNTY OFFICE BLDG
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City | CAIRO
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State | NY
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Zip | 12413-2868
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Country | US
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Telephone | 518-622-9163
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Fax |
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Provider Business Mailing Address
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Address Line | 31 FABRELLO LN
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City | PINE PLAINS
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State | NY
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Zip | 12567-5412
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Country | US
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Telephone | 845-489-8295
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 14506
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 406723
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License Number State | NY
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