JUSTIN MICHEAL SULLIVAN (NPI# 1821634239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821634239 |
| Entity Type | Individual |
| Full Name | JUSTIN MICHEAL SULLIVAN |
| Credential | PA-C |
| Practice Address |
205 E Laurel Rd Stratford NJ 08084-1301 |
| Practice Telephone | 8563442315 |
| Mailing Telephone | 8445422273 |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2020-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 25MP00553600 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0714275 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548525090 | Justin J Sullivan | Specialist | 3000 Rogers Rd Ste 110, Wake Forest, NC 27587 | 2012-07-11 |
| 1467632919 | Justin Sullivan | Physical Therapist | 360 State Route 17m Ste 4, Monroe, NY 10950-3444 | 2007-11-13 |
| 1023307139 | Justin L Sullivan | Internal Medicine | 810 Fairgrove Church Rd, Hickory, NC 28602-9617 | 2011-03-30 |
| Street Address |
205 E LAUREL RD |
| City | STRATFORD |
| State | NJ |
| Zip Code | 08084-1301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477532802 | Jeffrey Friedman | Internal Medicine | 205 E Laurel Rd, 1st Floor, Stratford, NJ 08084-1301 | 2006-01-13 |
| 1497218036 | Alicia Villaescusa Karagianes | Physician Assistant | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2019-04-10 |
| 1235619933 | Sierra Miller | Physician Assistant | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2018-08-21 |
| 1114426954 | Amy Carlin | Physician Assistant | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2018-02-07 |
| 1235517707 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Family Medicine | 205 E Laurel Rd, 2nd Floor, Stratford, NJ 08084-1301 | 2015-05-15 |
| 1619365152 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Internal Medicine | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2015-01-07 |
| 1437410990 | Kennedy Medical Group Practice, P.C. | Internal Medicine | 205 E Laurel Rd, 2nd Floor, Stratford, NJ 08084-1301 | 2012-05-31 |
| 1205114071 | Kennedy Medical Group Practice, P.C. | Internal Medicine | 205 E Laurel Rd, 1st Floor, Stratford, NJ 08084-1301 | 2011-07-28 |
| 1639120462 | Jeffery Ranalli | Internal Medicine | 205 E Laurel Rd, 1st Floor, Stratford, NJ 08084-1301 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780209684 | Emily Lacount | Student in an Organized Health Care Education/Training Program | Louis Balsama, D.o., Program Director, Rowansom 42 E. Laurel Rd, Stratford, NJ 08084 | 2020-06-16 |
| 1356903124 | Maziyar Daneshvar | Student in an Organized Health Care Education/Training Program | Rowansom 42 E Laurel Road, Suite 3100, Philadelphia, NJ 08084 | 2019-07-02 |
| 1598321788 | Sylvia Orozco Silberman | Student in an Organized Health Care Education/Training Program | Fm: Alison Mancuso, Do, Prog Dir, Rowansom 42 E Laurel Road, Suite 2100a, Stratford, NJ 08084 | 2019-05-14 |
| 1831682939 | Shriya Jakkidi Reddy | Student in an Organized Health Care Education/Training Program | Rowansom 42 E. Laurel Road, Suite 3100, Stratford, NJ 08084 | 2018-06-13 |
| 1003336751 | Maulik D Shah | Student in an Organized Health Care Education/Training Program | 42 East Laurel Rd, Suite 3100, Stratford, NJ 08084 | 2017-06-23 |
| 1225566946 | Bhumi Shah | Student in an Organized Health Care Education/Training Program | 18 E Laurel Road, Em: Anthony Dipasquale, Do, Prog Dir, Rowansom, Stratford, NJ 08084 | 2017-05-25 |
| 1902259393 | Ameena Javed Jiwani | Family Medicine | Rowan Som 42 E Laurel Road, Ste. 2100a, Stratford, NJ 08084 | 2016-07-20 |
| 1104276823 | Akshay Sridhar | Student in an Organized Health Care Education/Training Program | One Medical Center Drive, Suite 162, Stratford, NJ 08084 | 2016-06-14 |
| 1144692138 | Amanda Wu | Physical Therapist | 1255 Caldewell Road, Cherry Hill, NJ 08084 | 2015-10-29 |
| 1215313010 | Nathaniel Paul Havens | Student in an Organized Health Care Education/Training Program | 42 E. Laurel Rd., Suite 2100a, Stratford, NJ 08084 | 2015-08-04 |
| Find all providers in zip 08084 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588139604 | David A Crosby | Physician Assistant | 125 Pumpkin Ground Road, Stratford, CT 06614 | 2018-10-04 |
| 1225452386 | Colleen Elizabeth Driscoll | Physician Assistant | 59 Jefferson St, Stratford, CT 06615-7808 | 2014-02-10 |
| 1043445760 | Regina C K Eichenberger | Physician Assistant | 2505 Main St Ste 223, Stratford, CT 06615-5839 | 2009-05-26 |
| 1083897599 | Rosemary A Decicco | Physician Assistant | 205 E. Laurel Rd., Stratford, NJ 08084 | 2007-12-07 |
| 1306942511 | Catherine Haas Mcnulty | Physician Assistant | 18 E. Laurel Road, Stratford, NJ 08084 | 2006-09-15 |
| 1497218036 | Alicia Villaescusa Karagianes | Physician Assistant | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2019-04-10 |
| 1205391893 | Yunru Lai | Physician Assistant | 2876 Main St, Stratford, CT 06614-4984 | 2019-02-07 |
| 1235619933 | Sierra Miller | Physician Assistant | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2018-08-21 |
| 1265981096 | Taylor Joswiak | Physician Assistant | 212800 Stainless Ave, Stratford, WI 54484-4325 | 2016-09-21 |
| 1134502701 | Cynthia M Perez | Physician Assistant | 2890 Main St, Suite 2a, Stratford, CT 06614-4980 | 2015-07-01 |
| Find all providers in STRATFORD | ||||
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| 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.