Sullivan, Shannon

Sullivan, Shannon is an individual health care provider with primary practice located at 1729 Burrstone Rd , New Hartford NY 13413-1001. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Sullivan, Shannon can be contacted via phone (315) 798-1415.

Contact Information

Primary practice address
1729 Burrstone Rd New Hartford NY 13413-1001
Phone: (315) 798-1415
Fax: (315) 798-1700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 024013 New York

Profile Details

NPI number 1194716605
LBN Legal business name Sullivan, Shannon
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194716605 NPPES
New York MEDICAID 02290288

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