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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225128952 | NPPES |
| New Jersey | MEDICAID | 0079553 |
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