Sullivan, George John

Sullivan, George John is an individual health care provider with primary practice located at 208 Roanoke Ave , Riverhead NY 11901-2706. He recently has only one registered license in Behavioral Health & Social Service Providers / Rehabilitation, which is considered as his primary health care specialty. Sullivan, George John can be contacted via phone (631) 357-0173.

Contact Information

Primary practice address
208 Roanoke Ave Riverhead NY 11901-2706
Phone: (631) 357-0173
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X

Profile Details

NPI number 1992384200
LBN Legal business name Sullivan, George John
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2021
Last updated Apr 5th, 2021 - about 3 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 1992384200 NPPES
New York Other K6043576401 EMBLEM HEALTH

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