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Contact Information

PAUL J SULLIVAN
11-12 BROADWAY AVE
GLOVERSVILLE, NY12078
 Phone: 518-725-4310
 Fax: 518-725-2556
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for PAUL J SULLIVAN · (Male)

NPI Number 1356824486
Status Active
Credentials
Entity Individual
Enumeration date 09/14/2018
Last updated 09/14/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 28067
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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