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1104051549
JACQUELINE GLORIA SULLIVAN
BRONX, NY
NPI
1104051549
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2009-05-28
Last Update Date
2009-05-28
Business Address
Mrs. JACQUELINE GLORIA SULLIVAN PA
111 E 210TH ST
BRONX, NY 10467-2401
Phone number: 718-920-4321
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Mailing Address
Mrs. JACQUELINE GLORIA SULLIVAN PA
232 SPRINGMEADOW DR UNIT C
HOLBROOK, NY 11741-4137
Phone number:
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