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NPI Code Detail

MEDICARE: MISS KAREN ELIZABETH SULLIVAN M.S., CCC-SLP

MEDICARE: MISS KAREN ELIZABETH SULLIVAN M.S., CCC-SLP
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
1235Z00000XSpeech-Language Pathologist0177571NY

General Provider Information

NPI Number : 1003118639
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KAREN ELIZABETH SULLIVAN M.S., CCC-SLP
Provider Business Mailing Address
First Line : 25 E 104TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10029-4402
Country : US
Telephone Number : 212-289-4872
Fax Number :
Provider Business Practice Location Address
First Line : 25 E 104TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10029-4402
Country : US
Telephone Number : 212-289-4872
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2010
Last Update Date : 10/09/2020

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Directions to “ MISS KAREN ELIZABETH SULLIVAN M.S., CCC-SLP” Practice Location

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