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NPI Code Detail

MEDICARE: ERICA LYNN O'SULLIVAN

MEDICARE: ERICA LYNN O'SULLIVAN
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 Pathologist
2235Z00000XSpeech-Language PathologistNJ

General Provider Information

NPI Number : 1023537651
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA LYNN O'SULLIVAN
Provider Business Mailing Address
First Line : 20 LEHAVRE CT
Second Line :
City : TRENTON
State : NJ
Zip : 08619-4720
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 207 HUDSON TRCE
Second Line :
City : AUGUSTA
State : GA
Zip : 30907-2010
Country : US
Telephone Number : 706-823-5250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2017
Last Update Date : 12/05/2024

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Directions to “ ERICA LYNN O'SULLIVAN ” Practice Location

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