Provider Demographics
NPI:1831349273
Name:SULLIVAN, JANINE MARIE (NP)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:MARIE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:MARIE
Other - Last Name:HOEFLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 E 38TH ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2772
Mailing Address - Country:US
Mailing Address - Phone:646-501-7390
Mailing Address - Fax:646-501-7335
Practice Address - Street 1:333 E 38TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2772
Practice Address - Country:US
Practice Address - Phone:646-501-7390
Practice Address - Fax:646-501-7335
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332961-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily