PAUL EDWARD SULLIVAN (NPI# 1417953647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417953647 |
| Entity Type | Individual |
| Full Name | PAUL EDWARD SULLIVAN |
| Credential | D.P.M. |
| Practice Address |
925 Chestnut St Fifth Floor Philadelphia PA 19107-4216 |
| Mailing Address |
833 Chestnut St Suite 1402 Philadelphia PA 19107-4414 |
| Practice Telephone | 2673393500 |
| Practice Fax Number | 2674791321 |
| Mailing Telephone | 8003219999 |
| Mailing Fax Number | 2673393761 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2015-11-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
SC003899L | PA | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
25MD00267000 | NJ | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 8925704 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356824486 | Paul J Sullivan | Counselor | 11-12 Broadway Ave, Gloversville, NY 12078 | 2018-09-14 |
| 1952754400 | Paul Ryan Charles Sullivan | Internal Medicine | 1093 Prospect Ave, West Hartford, CT 06105-1104 | 2016-07-20 |
| 1427289347 | Paul Michael Sullivan | Counselor | 5397 Howard Rd, Petoskey, MI 49770-8815 | 2009-07-28 |
| 1013042613 | Paul Joseph Sullivan | Physical Therapist | 14 Gawaine Rd, North Easton, MA 02356-2642 | 2007-02-22 |
| 1730247032 | Paul Damian Sullivan | Psychiatry & Neurology | 11117 Waycroft Way, Rockville, MD 20852-3216 | 2006-12-05 |
| 1386721504 | Paul Michael Sullivan | Internal Medicine | 44060 Woodward, Bloomfield Hills, MI 48302 | 2006-11-01 |
| 1184728875 | Paul J. Sullivan | Physician Assistant | 36000 Darnall Loop, Room 1272, Carl R. Darnall Army Medical Center, Ft Hood, TX 76544 | 2006-09-12 |
| 1548822885 | Paul Francis Sullivan | Behavior Technician | 36 Oak Ln, Mountain View, CA 94040-2629 | 2019-07-08 |
| 1891278669 | Paul Joseph Sullivan | Psychologist | 525 E 68th St Fl 11, New York, NY 10065-4870 | 2018-09-07 |
| 1245695402 | Paul Sullivan | Physical Therapist | 34 Manchester Ave, Forked River, NJ 08731-1366 | 2015-12-15 |
| Street Address |
925 CHESTNUT ST FIFTH FLOOR |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-4216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548868102 | Mary Elizabeth Rodgers | Social Worker | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2020-10-15 |
| 1679108559 | Sarah Jane Miranda | Internal Medicine | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2020-03-11 |
| 1558993493 | Noam Shohat | Student in an Organized Health Care Education/Training Program | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2020-02-09 |
| 1871130625 | Scott Paul Sheridan | Physical Therapist | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2019-11-27 |
| 1063057784 | Stephanie Dipaolo | Nurse Practitioner | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2019-11-18 |
| 1639732464 | Alexander Duffy | Student in an Organized Health Care Education/Training Program | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2019-04-17 |
| 1851856165 | Haley Ann Klose | Nurse Practitioner | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2019-01-31 |
| 1609347855 | Kathryn Yingling | Nurse Practitioner | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2018-12-16 |
| 1154808285 | Linda H Roberts | Social Worker | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2018-07-21 |
| 1902392012 | Siri Zirkle Larsen | Nurse Practitioner | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2018-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720270663 | Barbara A Rosenberg | Podiatrist | 6341 Sylvester St, Philadelphia, PA 19149-2837 | 2007-08-14 |
| 1235186586 | Anne Sonoga | Podiatrist | Dvamc Philadelphia, University & Woodland Avenue, Philadelphia, PA 19104 | 2006-05-30 |
| 1174500722 | Ronald J Small | Podiatrist | 104 W Cheltenham Ave, Philadelphia, PA 19120-1027 | 2005-12-26 |
| 1255334439 | Richard Rettig | Podiatrist | 1335 W Tabor Rd, Ste 206, Philadelphia, PA 19141-3040 | 2005-05-23 |
| 1780066431 | Faramarz Fanaian | Podiatrist | 1304 Rhawn St, Philadelphia, PA 19111-2870 | 2015-06-18 |
| 1174739940 | Northeast Family Foot Care, PC | Podiatrist | 9892 Bustleton Ave, Suite 303, Philadelphia, PA 19115-2184 | 2007-05-16 |
| 1912080722 | Donna Goelzer Myers | Podiatrist | 9892 Bustleton Ave, Suite 303, Philadelphia, PA 19115-2184 | 2006-10-23 |
| 1255349031 | Karen Galli | Podiatrist | 3900 Woodland Ave, Podiatry (112), Philadelphia, PA 19104-4551 | 2006-08-04 |
| 1851316756 | Susan Gamble | Podiatrist | Dvamc Philadelphia, University and Woodland Avenues, Philadelphia, PA 19104 | 2006-07-12 |
| 1679504443 | Leonard Menaker | Podiatrist | 2401 Pennsylvania Ave, Suite#1d5, Philadelphia, PA 19130-3010 | 2006-07-06 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
Please comment or provide details below to improve the information on PAUL EDWARD SULLIVAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.