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NPI Code Detail

MEDICARE: ALLISON SULLO

MEDICARE: ALLISON SULLO
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
1104100000XSocial Worker125533NY

General Provider Information

NPI Number : 1629929948
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON SULLO
Provider Business Mailing Address
First Line : 1985 MARCUS AVE
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11042-2008
Country : US
Telephone Number : 718-559-0516
Fax Number : 718-559-0516
Provider Business Practice Location Address
First Line : 3600 ROUTE 112
Second Line :
City : CORAM
State : NY
Zip : 11727-4116
Country : US
Telephone Number : 631-920-8630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2026
Last Update Date : 02/04/2026

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Directions to “ ALLISON SULLO ” Practice Location

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