| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KELLY SULLIVAN | 1508597717 | 2022-06-19 |
Kelly Sullivan is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1508597717. Registration indicates Kelly Sullivan is a provider of services with a specialization in Speech, Language and Hearing Service Providers, Speech-Language Pathologist (Speech-Language Pathologist, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Speech-Language Pathologist, Speech, Language and Hearing Service Providers)
| Entity Type | Individual |
| Provider Name | Kelly Sullivan |
| Practice Office Address | 300 GARDEN CITY PLZ STE 350 GARDEN CITY, NY US |
| Practice Office Telephone | 5167479030 |
| Mailing Address | 300 GARDEN CITY PLZ STE 350 GARDEN CITY, NY 115303358 US |
| Code | Practice | License No State |
|---|---|---|
| 235Z00000X PRIMARY | Speech, Language and Hearing Service Providers Speech-Language Pathologist Speech-Language Pathologist Speech/Occupational/Physical Therapy/Chiropractor Speech-Language Pathologist Speech, Language and Hearing Service Providers |