Sullivan, Jared M.

Sullivan, Jared M. is an sole proprietor health care provider with primary practice located at 1117 Us Highway 46 Ste 202 , Clifton NJ 07013-2450. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Sullivan, Jared M. can be contacted via phone (973) 779-1221.

Contact Information

Primary practice address
1117 Us Highway 46 Ste 202 Clifton NJ 07013-2450
Phone: (973) 779-1221
Fax: (973) 778-6014
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 25MA076546 New Jersey

Profile Details

NPI number 1225128952
LBN Legal business name Sullivan, Jared M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 13th, 2006
Last updated Jul 8th, 2007 - about 17 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 1225128952 NPPES
New Jersey MEDICAID 0079553

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